Glaucoma detection training of community healthcare workers using portable devices in Nigeria

Glaucoma, an irreversible blinding eye disease caused by optic nerve damage, remains a major public health challenge in sub-Saharan Africa, where it occurs earlier and progresses more aggressively than in other regions. Accessibility and affordability remain major barriers to timely diagnosis and treatment in low- and middle-income countries (LMICs).

To assess the ability of community health workers (CHWs) without prior ophthalmic training to use portable diagnostic tools for early detection and referral of possible glaucoma cases in Abuja, Nigeria.

This feasibility study was conducted from June to September 2024 in three community health centres in Abuja. Fifteen CHWs (14 females, 1 male) were trained over 3 days using didactic lectures, practical demonstrations, and hands-on sessions on four portable devices: PEEK Acuity, iCare tonometer, Eyecatcher visual field analyser, and Remidio handheld fundus camera. Pre- and post-training assessments were conducted, with an 80% pass mark required. A simplified scoring system based on test findings guided referral decisions.

All CHWs achieved scores of 80% or higher post-training, showing significant improvement in glaucoma knowledge and testing proficiency. Initial challenges with the iCare tonometer and fundus camera improved with practice.

Community health workers can effectively use portable diagnostic tools for glaucoma screening and referral in primary care settings. Their involvement could enhance early detection and contribute substantially to reducing glaucoma-related blindness in resource-limited settings.