Profile of the glaucomas and intervention in a large eye care centre in south-east Nepal.

INTRODUCTION Glaucoma is the second leading cause of blindness worldwide. OBJECTIVE To estimate the prevalence and risk factors of glaucoma and modes of therapeutical intervention in a rural population of a developing country. PATIENTS AND METHODS A single centre-based cross-sectional study was carried out over a seven-month period in Sagarmatha Choudhary Eye Hospital (SCEH), Lahan/NEPAL, including the patients with glaucoma. OUTCOME MEASUREMENT The patients' demography, type of the glaucomas, visual acuity, vertical cup-disc ratio, intra-ocular pressure and visual field findings were the parameters studied. RESULTS A total of 3986 eyes with suspected glaucoma were identified. 53.7% of the patients were between 41-60 years of age. 53.9% were male. 26.5% were blind or severely visually impaired. 37.2% had IOP more than 35 mmHg. 46.4% had vertical cup-disc ratio (VCDR) higher than 0.8. Severe visual field defects were found in 28.4% eyes. 35.3% eyes had primary angle-closure glaucoma, 22.6% eyes primary open-angle glaucoma, and 14.6% eyes normaltension glaucoma. 10.2% eyes suffered from lens induced glaucoma. Only in 9 eyes was pseudoexfoliation syndrome with glaucoma diagnosed. 25.7% eyes were advised for trabeculectomy. 11.5% eyes underwent extra-capsular cataract surgery. IOP lowering medication was prescribed in 5.9% patients. CONCLUSIONS The most common glaucoma seen in the out-patient department of a large eyecare centre in South-East Nepal is primary angle-closure glaucoma. 25% of the glaucoma patients are visually impaired or blind at the time of presentation. In more than one-fourth of the patients, trabeculectomy is the therapy of choice.