Opportunistic Screening for Glaucoma Amongst Glaucoma Patients’ First Degree Relatives who Accompany them to Glaucoma Clinic

Glaucoma

Abstract

Introduction: Screening for glaucoma is an important tool for reducing incidence of blindness and visual impairment. Detection of the  condition in its earlier stages by effective screening should result in reduced morbidity and improved quality of life1 . The risk ratio  of developing primary open angle glaucoma in persons with positive family history has been estimated to be 9.2 and increased  prevalence of glaucoma has been found in persons whose first-degree relatives suffer primary open angle glaucoma2,3. This study  aims at identifying people with glaucoma and glaucoma suspects among first degree relatives who accompanied known glaucoma  patients to the Glaucoma clinic at University of Port Harcourt Teaching Hospital, Port Harcourt.

Methods: It was a prospective clinic- based study of first-degree relatives of Primary open-angle glaucoma patients. All participating individuals underwent comprehensive  eye examination including vision screening, refraction, slit lamp biomicroscopy, applanation tonometry, gonioscopy and dilated fundus  examination. Persons with definite or suspected glaucoma underwent threshold standard automated perimetry. A diagnosis  of primary open angle glaucoma was based on the following criteria9 : i. Open angle documented on gonioscopy ii. An optic nerve  head cup/disc ratio >0.6 with typical features of notching of neuroretinal rim, excavation, thinning or sloping of neuroretinal rim in the  superior or inferior sector of the optic nerve head in at least one eye. Visual field defects matching of the nerve head  changes on the  visual field with pattern standard deviation abnormal at 5% level or less; with cluster of at least three abnormal points in the nasal, paracentral or arcuate region of the visual field with at least one point at <1%. Borderline or abnormal glaucoma hemifield test on  automated perimetry alone without matching disc changes were not considered abnormal.