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Increased awareness of glaucoma, early diagnosis key to treating disease in sub-Saharan Africa
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BOSTON — There are many challenges to treating primary open-angle glaucoma in Africa, including few resources spent on patient care and limited health care resources, but they can be overcome by increasing knowledge and treatment of the disease, a clinician said.
"The uptake of eye care services can be improved by creating more awareness, especially among the high-risk groups," A.O. Ashaye, MD, MSc, said at the World Glaucoma Congress here.
Dr. Ashaye, of the Department of Ophthalmology, University of Ibadan, Nigeria, outlined managing glaucoma care in Nigeria. Primary open-angle glaucoma is the main subset of the disease encountered in the country, she said. At the clinic where she works, 22% of patients were blind in both eyes at presentation because of the disease.
She said more awareness of the disease and the importance of early diagnosis are important, and advocates can use telemedicine and radio to promote that message. Effective treatment, including affordable medication and safe surgery, are also important, she said.
Dr. Ashaye’s clinical observations are entirely in line with epidemiological evidence pointing to a higher incidence of primary open-angle glaucoma (POAG) and a higher burden of glaucoma-related blindness in people with direct African roots compared to people from other ancestral groups. It is not feasible to deploy the current treatment paradigm for POAG in the setting where Dr. Asheye provides ophthalmic care. Research efforts to discover the upstream factors contributing to POAG in people of all ancestries will lead to more cost-effective treatments. Several large-scale genetics studies in people of various ancestries are currently under way with the goal of discovering the genetic architecture of POAG. Armed with this information, directed basic science research may lead to novel disease targets that actually prevent POAG. New treatments founded in knowledge of the molecular mechanisms of disease will give Dr. Asheye, and physicians worldwide, the ability to eradicate POAG-related blindness.
– Louis R. Pasquale, MD
Massachusetts Eye
and Ear Infirmary