SUNDAY 3RD APRIL, 2016 – UWI TODAY
9
HEALTH – GLAUCOMA
This is a comment on the method, patient numbers,
enthusiasm of the students and some insights into the results.
This is the third time we have observed Glaucoma Week, but the
previous two occasions were very low-profile attempts due to
equipment insufficiency, busy staff and students who were not full
appraised of the importance of the situation. After this resounding
success the occasion will definitely be an annual occasion to be
observed in our calendar.
The time allotted to the screening was two hours per day, with
a final four-hour outreach screening session at the Health Services
Unit at the St. Augustine Campus, which was overrun by numbers!
The screening exam, of necessity, consisted of a full history,
ophthalmoscopy (examination of the back of the eye or fundus)
and the measurement of the patient’s visual acuity and intraocular
pressure (IOP).
These checks were sufficient to unlock a number of clinical
data.
Overall, during the 14 hours of screening, we examined 178
patients. This included 13 old glaucoma patients who were being
treated and stopped the treatment as their drugs ran out, or who
were on a treatment programme, but did not understand what it
was all about. These people were counselled, given information
on the condition and asked to go back to their clinics to continue
their treatment, which was a victory in itself and what primary
care is all about.
During screening we picked up eight (5%) new glaucoma
patients who were unaware that they had the condition and we
arranged for them to see a specialist for treatment, which was the
main aim of the exercise. We also uncovered 18 (10%) suspected
patients with ocular hypertension whom we have asked to come
in for a more detailed examination and whom we will place on
a management programme if they are not confirmed as being
glaucomatous.
A third of our patients (60) came from families with
confirmed glaucoma, but were unaware that they were likely to
develop the condition. This is a very high number and it suggests
that education of the population about this devastating disease is
sadly lacking and needs to be addressed.
Together these two figures (new and suspected cases, 5% +
10%) add up to 15% of our examined population having or being
suspected of having the disease, which conforms to the new,
unaudited National Eye Survey of Trinidad and Tobago (NESTT)
figures, conducted by UWI Optometry (and others) for the
GORTT. If this screening project was not undertaken these people
most likely would have gone on to develop glaucoma and would
probably have reported for treatment when it was well established,
and may have even gone on to lose much of their sight.
Many patients had other conditions as some (46, 25%) didn’t
realise that their diabetes had ocular consequences, but knew that
their parents had the condition (diabetic-related eye disease).They
were advised to see their doctor or go to the local health centre
for advice. Others had mature cataracts (11, 0.5%), and were
referred to the hospital eye services for consultation while some
(19, 10.6%) had early cataracts and were put on a management
list for observation at our clinic, or referred to their doctor for
further advice.
There were 11 (6%) patients who were urgently referred to
private ophthalmologists or to the hospital eye service for attention,
one being a patient with Papillodema, whom we had seen in
a screening session previously and asked to return for further
examination. This is a very serious condition due to pressure in
the craniumwhich, if not treated immediately, could lead to stroke,
blindness and, in very severe cases, to death.
Quite a large number (62, 34.8%) of patients felt they had
Saving Sight
Screening can help save vision
B Y D R . S U B A S H S H A R M A
International Glaucoma Week 2016
was observed atThe UWI’s Optometry
Unit of the Faculty ofMedical Sciences,
by mainly the second- and third-year
students performing ocular screening
on members of the public. This was
coordinated by
Dr. Subash Sharma
,
the Clinical Coordinator with help
from other members of the Unit.
hazy vision, but left it alone or were unaware that it was caused by
a cataract(s) althoughmost had diabetes and hypertension. This is
another instance of poor education of the public on eye conditions
and must be addressed urgently.
This small project has picked up large numbers of conditions
that, if they were not discovered, would go untreated and would
have led to unnecessary eye diseases, suffering, loss of many man-
Optometry student, Cassiana Sookram,
measures the Intra Ocular Pressure (IOP) of
the patient as part of the screening process.
hours and production and, ultimately, unemployment, misery and,
finally, blindness and death.
Much of this could be avoided by doing ocular screening
throughout the country to pick up these conditions early and offer
solutions. The Ministry of Health has agreed to make a NESTT
bus available for this purpose and we await its arrival anxiously.
Dr. Subash Sharma discusses ocular
problems with a patient during
Glaucoma Week Screening.
