Glaucoma Has No Cure, Regular Eye Examination Important (2)
“THERE are a lot of challenges to the management in Nigeria. Firstly is the issue of late presentation to eye specialist where 85 per cent present with blindness in one eye and moderate to severe visual impairment in the other eye. This is basically due to late awareness of the disease, and poor knowledge. Secondly those that are already being treated have poor knowledge, poor response to treatment, financial constraints, denial of the disease condition, poor compliance to treatment due to prohibitive cost of drugs. Averagely, 8,000 to 10,000 naira is required for drug procurement on a monthly basis.
“In addition poor management of associated co morbid conditions such as hypertension, hypotension, diabetes could predispose to rapid progression of the disease. Poor adherence to treatment regimen is also another factor. In some situations poor availability of drugs is an important factor. Where drugs are available, counterfeiting of drugs is another content factor.
“Thirdly, low acceptance of surgical intervention in our society has led to increased incidence of blindness. A situation where compliance with drugs is questionable, surgical option is a viable option, but this not accepted in our society for fear of blindness complicating the surgery. Lastly, Glaucoma is such an aggressive disease in blacks. Blacks are more likely to go blind than Caucasian. 1.29 per cent in Caucasian and 4.74 per cent in blacks (Baltimore Eye Survey. In Nigerians above 40 years, it is responsible for 16.7 per cent of blindness and 15 per cent in Africa, She says.
Onakoya, who is also head of glaucoma services and fellow of West African College of Surgeons and National Post graduate Medical College of Nigeria emphasised the need to increase the awareness of the population on disease glaucoma through health education and promotion.
“The avenues available to be explored are public lectures, dissemination of the information on print and electronic media. Teachings on glaucoma in public places such as churches, mosques and community town halls, distribution of educational leaflets on glaucoma in public places and eye hospitals. Early detection through regular eye examination once every two years in people over 35 years of age and yearly examination in people whose family members went blind especially, when cause is unknown. Integration of Case detection of Glaucoma at Primary Eye care level at the health centres through the training of community health workers simple eye tests to detect glaucoma and referral of such cases to secondary centres.
Also for identification of family members of the blind in the community and refer to secondary centres for appropriate examination and treatment where necessary. Promoting good compliance and adherence in sufferers, and also teaching the natural cause of the disease.”
Onakoya says, “Providing appropriate rehabilitation measures for those with severe visual impairment through provision of low visual aids. Training of more Glaucoma specialist to function at both secondary and tertiary health institution is paramount. Advocacy to policy makers on the need to include glaucoma on the list of Non Communicable diseases to be tackled under MDG and also for rebates on importation of glaucoma medications to reduce the cost to end-users.
Lifestyle changes will help, moderate exercise and eating a lot of fruits and vegetables. Ensure blood pressure is well controlled and those with hypotension seek appropriate treatment. General wellness will improve the health of the optic nerves thereby helping to improve the quality of life in glaucoma, She advised.
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