High prevalence of undiagnosed glaucoma in West Africa

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1. Out of 5,603 West Africans interviewed, 362 (6.8%) were identified as having glaucoma. Age was found to be a significant risk factor, with 3.7% of 40-49 year olds and 14.6% of those over 80 years old affected. 

2. Only 12 of the patients diagnosed with glaucoma (3.3%) were aware that they had the disease. 

Study Rundown: The Tema Eye Survey is the first study conducted in West Africa to gauge glaucoma prevalence in this region. The study demonstrates that the prevalence of glaucoma in West Africa is higher than initial estimates, based on studies in East and South Africa. In contrast to the 1-2% of Americans affected by glaucoma, 6.8% of West Africans have the disease, emphasizing the significance of ethnicity as a risk factor. The relatively high percentage of 40-year old individuals affected by the disease indicates that glaucoma may occur at an earlier age in West Africans. The fact that 96.7% of glaucoma patients were unaware of their diagnosis is concerning, and reflects the general worldwide trend, highlighting the importance of regular eye exams. While this study was conducted in one city, the authors report that their cohort was representative of the region. Similar well-structured studies in other regions will be necessary to fully characterize the differences in glaucoma prevalence and potential genetic etiologies amongst Africans.

Click to read the study in JAMA Ophthalmology

In Depth [cross-sectional study]: In this survey, over 5,000 individuals living within Tema, Ghana were interviewed, and only those patients in whom glaucoma was suspected (based on visual field testing, intraocular pressure measurement, and cup-to-disc ratio) were evaluated further. After examination, qualifying patients were diagnosed with glaucoma based on strict definitions. Approximately 6.8% (362 individuals) were diagnosed with glaucoma, of which 12 patients were actually aware of their diagnosis prior to this exam (3.3%). 14.4% of patients were considered visually impaired from glaucoma, while 2.5% of patients were defined as blind according to World Health Organization criteria. The prevalence of glaucoma amongst 40-49 year olds was only 3.7%, while this increased to 14.6% among those above age 80. 

By Swarup Swaminathan and Andrew Bishara

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