MANAGEMENT OF ABSOLUTE GLAUCOMA: EXPERIENCE OF RAS DESTA DAMTEW HOSPITAL, ADDIS ABEBA, Ethiopia
Introduction: Absolute glaucoma is the final stage of blindness in glaucoma and it is the most common reason leading to painful blind eye. This study was conducted to identify the frequency of absolute glaucoma, pain associated with glaucoma subtypes and practical treatment options for case presenting with the condition in the Ethiopian setting.
Methods: This is hospital-based cross sectional study was conducted from Sep 1,2013 to Dec 30, 2013 at Ras Desta Hospital, Department of Ophthalmology. The diagnosis of absolute glaucoma was made based on history and ophthalmic examinations. Once diagnosed, those who had pain were started on Atropine and Dexamethasone eye drops. If pain did not-resolve, retro-bulbar injection of absolute alcohol was given. Enucleation was done if the pain persisted after the injection of absolute alcohol. Data was entered on to a computer and analyzed using SPSS for windows.
Results: The study involved a total of 111 patients with absolute glaucoma. The majority of absolute glaucoma patients, 79(71.2%), had no pain. The remaining 32(28.8%) had pain and 21(65.6%) of them had got relief with topical steroid and atropine eye drops. For non-respondents, retrobulbar absolute alcohol injection was given and 7(21.9%) improved. Finally, the remaining 4(12.5%) patients eye were enucleated to relief intractable pain.
Conclusion: -Management of painful absolute glaucoma in our setting should be started with topical steroid and atropine eye-drops. If this fails, the next step is retrobulbar injection of absolute alcohol, and finally if pain is intractable, enucleation is recommended.
Key words: - Absolute glaucoma, pain, Management, no light perception, Ethiopia
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