Is angle closure glaucoma a problem in Nigeria?

PURPOSE The aim of this study was to report the characteristics of angle closure glaucoma (ACG) in eye clinic patients of University College Hospital (UCH), Ibadan, Nigeria. MATERIALS AND METHODS A total of 336 consecutive new glaucoma patients of all age groups who presented to the glaucoma clinic of UCH over a 1 year period between December 2009 and November 2010 were evaluated. Each patient had a complete ophthalmic evaluation, including relevant history, visual acuity testing, slit-lamp examination, applanation tonometry, gonioscopy with a Posner lens and standard automated perimetry. Patients with previous incisional surgery and corneal opacities precluding gonioscopy were excluded. RESULTS Of the 336 patients, 60 eyes of 31 patients (9.2%) had angle closure with or without glaucoma. The mean age was 59.0 ± 15.4 years and there was a female predilection (58.1%). Forty eight eyes (80%) had primary angle closure glaucoma, eight eyes (13.4%) had primary angle closure, two eyes (3.3%) had plateau iris syndrome and two eyes (3.3%) had secondary ACG (post uveitis). Also, 45.2% of the patients presented with at least one blind eye (<3/60). The mean intraocular pressure (IOP) at presentation was 28.7 ± 12.7 mmHg. A total of 54.8% presented with advanced glaucoma (mean deviation >12 dB). Twelve eyes underwent laser iridotomy or surgical iridotomy and others had trabeculectomy or antiglaucoma medications. Mean IOP post intervention was 17.4 ± 6.9 mmHg. CONCLUSION ACG is not an uncommon disease. Early and effective diagnosis is important to prevent blindness.