Welcome to the course and Week 1

Glaucoma is a leading cause of irreversible blindness. Glaucoma is chronic and lifelong! The risk of glaucoma increases with age. It occurs globally but the risk of blindness is greater in low- and middle-income countries. These are some of the facts about glaucoma.

Globally there is poor public and patient knowledge of glaucoma, which adversely influences uptake of eye care services. Individuals’ risk of vision loss could be reduced if we successfully encouraged those at risk to obtain a comprehensive ophthalmic examination on a regular basis.

In the UK, a study was undertaken at community level (amongst an Asian population in Ealing, London) to assess the health knowledge about glaucoma. Knowledge about glaucoma was assessed with 300 patients using 14 true / false questions, followed by an interview.

• 67(22%) people had heard the term ‘glaucoma’ compared to 298 persons (99%) who knew about cataract. There was also no understanding of glaucoma beyond having heard the word. These people had heard about glaucoma from their GP, friend or relative. They had never come across the term in the wider media. Knowing about glaucoma did not result in any specific behaviour to seek or attend regular eye tests.
• Using this baseline, the researchers designed a radio and television campaign to raise awareness about glaucoma. Following the campaign, the proportion who had heard of glaucoma rose to 163 persons (53%), however the degree of knowledge about glaucoma did not really improve nor was there an increase in eye testing within the community. Information alone was insufficient to support a behaviour change!

Another study in Singapore, interviewed 105 patients who presented with an acute painful attack of angle closure glaucoma. They found that only 22.9% had heard about glaucoma. Lack of awareness was associated with increasing age, lack of formal education, and unemployment. A significant proportion of patients seek medical attention late.

Hospital-based studies regularly report late presentation of glaucoma when visual loss has already occurred.

As you go through this course, consider closely what can be done to raise awareness about glaucoma, understand the barriers to access of services, what types of services are required, and how can glaucoma programme deliver earlier detection and what must be done to support patients with glaucoma.