Glaucoma is a common sight threatening disease that affects the optic nerve. If not diagnosed, monitored and treated correctly, glaucoma can result in severe loss of vision or blindness. Therefore, successful management of glaucoma requires lifelong monitoring and treatment to prevent or minimize further vision loss; on average a person diagnosed with glaucoma will have one initial visit and 40 follow up visits.
People with glaucoma often do not experience symptoms until the disease is advanced and there has already been considerable damage to the person’s vision.
Therefore, people at high risk of glaucoma need to be monitored to diagnose and treat glaucoma at an early stage. More than fifty percent of glaucoma in the community remains undiagnosed; previously undetected cases are largely identified at routine sight tests.
The commonest type of glaucoma in Ghana is Primary open angle glaucoma (POAG).
The test procedure and processes within the ICEID glaucoma service for both Virtual and face-to-face appointments as per global standards is as follows;
- Visual acuity testing at each visit;
- Threshold automated visual fields at intervals clearly specified by the referring consultant/ delegated glaucoma reviewer;
- Intraocular pressure (IOP) measurement using a validated and appropriately calibrated tonometer at each visit;
- Disc imaging using a validated method of imaging the optic disc at intervals clearly specified by the consultant/ delegated glaucoma reviewer;
- Central corneal thickness (CCT) measured at least once, if not previously recorded.
- A Van Herrick or equivalent objective (e.g. optical coherence tomography) measurement of the anterior chamber angle depth as specified by the referring consultant/delegated glaucoma reviewer.
- A recording of the patient’s compliance to treatment, where appropriate, and any difficulties arising since the last visit.
The management tool kit we use at ICEID was formulated by a group of high-level glaucoma experts and general ophthalmologists. It is a practical toolkit for glaucoma management customized for descents of Sub-Saharan Africa (SSA). It is supported by the International Council of Ophthalmology (ICO).
Early diagnosis and management is the way to go with Glaucoma.
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