Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Late Presentation of Primary Open Angle Glaucoma and its Predictors at a Tertiary Eye Care Hospital in Pakistan

Hijab Arshad*, Mahmood Ali, Saad Alam Khan, Farah Akhtar and Abdul Mueed

Background: To determine stages of glaucoma and to identify predictors of late presentation.

Methods: A cross-sectional study was conducted in a tertiary eye hospital for four months. All patients diagnosed with primary open angle glaucoma for the first time were inducted and data was collected through an interview-based questionnaire. Classification into stages (early or late) was done based on visual field parameters and optic disc findings. Multivariable logistic regression was conducted to identify predictors of late presentation of glaucoma.

Results: Out of total sample (n=325), 82.2% of the cases (n=267) presented in hospital at late stage of glaucoma. Multivariable logistic regression model explained 18% to 29.6% variation in outcome variable. Late presentation was more likely in individuals with chief complaint of lacrimation (OR=2.45, p-value=0.02) and individuals who had delayed ocular examination as a result of long appointment date in hospital (OR=2.64, p-value=0.01), and individuals living a far distance from the hospital (OR=1.01/km, p-value=0.01).

Conclusion: Geographical accessibility is an important predictor of advanced glaucoma and screening should be focused aggressively on remote areas. It is essential to focus on building the capacity of optometrists and community ophthalmologists to ensure early diagnosis and management of glaucoma at the district level.

Published Date: 2021-11-16; Received Date: 2020-10-26