Challenges of Glaucoma Management in Nigeria: a Nationwide Perspective
Introduction: Glaucoma blindness is burdensome. Knowing glaucoma management challenges can reduce glaucoma blindness burden.The aim of this study was to determine challenges of glaucoma management in Nigeria
Methods: A descriptive cross sectional survey of Eye Care Physicians (ECP) on challenges of glaucoma management in Nigeria.
Results: One hundred and twenty three ECP, mean age 44, 56.1% males. Most (68.3%) always and 31.7% often manage glaucoma. Glaucoma features; most 98.4% affirm glaucoma deserves special consideration among eye conditions. Most (87.8%) at least agree glaucoma management is very challenging. Presentation and treatment affordability; most ECP at least agree: most patients present late (110, 89.4%), cannot afford standard investigations (87, 70.7%), cannot afford treatment 62.6%. However, most ECP at least disagree most patients readily access drugs through health insurance 83.7%.Preferred treatment; most ECP at least agree: most patients prefer medical treatment 91.9%. being comfortable managing glaucoma with drugs 66.7%, medical treatment being cost effective than trabeculectomy 82.9%, and being as comfortable performing trabeculectomy as with cataract surgery51.2%. Drugs Availability; most ECP at least agree: common anti-glaucoma drugs are readily available (112, 91.1%), and drugs are expensive for most patients (105, 85.4%). Equipment; many ECP at least disagree: there is functioning OCT to investigate glaucoma (76, 61.8%), there is fundal camera for optic disc photography (62, 50.4%).
Conclusions: Glaucoma management remains challenging especially late presentation, treatment non-affordability and inadequate resource for glaucoma care. Medical treatment is a preferred choice among patients. The need to improve uptake of surgical glaucoma services underscored.
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