Glaucoma case finding and management among optometrists in Ghana and Nigeria

This research contributes to the understanding of glaucoma case finding and management in Ghana and Nigeria. As areas of high glaucoma prevalence, gaining insight into this is paramount to identify barriers and better understand how to improve the detection of this blinding eye disease in an at-risk population.

This study was designed to investigate limiting factors to glaucoma case finding and management that exist within Ghana and Nigeria, including equipment and resource availability, management and referral options, optometrist skillset, and perceived socioeconomic barriers.

A descriptive, cross-sectional, online survey of licensed optometrists practicing in Ghana and Nigeria was conducted. The survey was distributed via an e-link and was designed to be self-administered. The survey consisted of 22 questions divided into three sections exploring (1) sociodemographic characteristics, (2) resources and skillset, and (3) case finding.

A total of 318 optometrists (105 Ghanaians, 213 Nigerians) responded to the survey. Nearly all optometrists (>95% from each country) performed glaucoma case finding, diagnosed glaucoma, and prescribed antiglaucoma medications. The cost of performing clinical tests and antiglaucoma medications were readily cited as barriers to glaucoma care. Equipment availability for key clinical tests (Ghana %; Nigeria %, respectively) included slit lamp biomicroscope (94%; 76%), binocular indirect ophthalmoscopy lens (46%; 38%), Goldmann applanation tonometer (79%; 30%), and automated visual field analyzer (38%; 60%). At least half of the optometrists from both countries perceived the need for extra training on at least one glaucoma case finding technique.

Optometrists from Ghana and Nigeria are involved in glaucoma case finding, diagnosis, and management. The main perceived barriers to optometric glaucoma care relate to the affordability of assessment/treatment and the need for additional training for some techniques. Equipment availability for key glaucoma investigations was also variable. Identifying and improving awareness of these barriers will facilitate strategies to improve the early detection and management of glaucoma in any nation that aims to promote health care system development.