Dr. Muchai GachagoM.B.Ch.B. M.Med.(Ophthal). ICO. FEACO

Tell Them More!

Hmmmm…What to tell eye care workers that they don’t

already know?

Tonnes of glaucoma!!!1

65m (2002) 80m(2020) Bilaterally Blind 8.4m

Lots untreated!!!

West: >50% undiagnosed.

India: 93% undiagnosed.2

Africa: Afraid to imagine!!!

This little %How are we handling it???We can look at:Knowledge statusState at presentationComplianceProgression of the condition

This little %How are we handling it???We can look at:Knowledge statusState at presentationComplianceProgression of the condition

Knowledge statusSource: Eye care worker - 90%

Name the condition: 60% 7% something close.

Big 3 in glaucoma!!!Optic Neuropathy:

Raised IOP:

VF loss:

Big 3 in glaucoma!!!Optic Neuropathy: 20%

Raised IOP:

VF loss:

Big 3 in glaucoma!!!Optic Neuropathy: 20%

Raised IOP: 40%

VF loss:

Big 3 in glaucoma!!!Optic Neuropathy: 20%

Raised IOP: 40%

VF loss: 10%

Beyond the big 3!!!Blinding 75%

Permanent 65%

ExpectationsMedical Rx

Surgery

Cure 1/3 1/3

Improved Vision

2/5 1/3

Knowledge & Motivation↑ knowledge → ↑motivation & adherence3

What to do?Spend a little more

time talking. Only 18% had been counseled.

Start thinking of ways to reach the other 95%

THANK YOU!!

ReferencesResnikoff S, et al. Bulleting of the World Health

Organization 2002 pg 844-851.Sannapaneni K, et al. Awareness of glaucoma in

the rural population of Southern India. Indian J. Ophthalmol 2005; 53: 205-208.

Cook PF, Bremer RW, Ayala AJ, Kahook MY. Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence. Clinical Ophthalmology 2010; 4: 1091–1101.