May 2022, Volume 72, Issue 5

Student's Corner

Rising glaucoma burden in Pakistan: A wake-up call for nationwide screening?

Sana Kazmi  ( 4th Year MBBS Student, Dow Medical College, Karachi,Pakistan. )
Adina Jabeen  ( 4th Year MBBS Student, Dow Medical College, Karachi,Pakistan. )
Rabbia Gul  ( 3rd Year MBBS Student, Dow International Medical College, Dow University of Health Sciences, Karachi,Pakistan. )

Madam, a significant rise of 55% in blindness and vision impairment in Pakistan has been reported over the last few decades, with blindness being the third most common eye disorder in the country.1 Among its different causes one of the leading cause is glaucoma, with an age standardized prevalence of 0.14 million.1 Glaucoma comprises a group of diseases that can result in irreversible damage to optic nerves and vision loss, it affects 3.1 million people around the world.2 The occurrence of glaucoma in elderly has increased in the last few decades and a significant rise in the burden of eye diseases, including glaucoma, in Pakistan, is predicted by the year 2025.1

Primary open-angle glaucoma is the most common form of glaucoma; it is asymptomatic in the early stages and patients usually present after significant damage to nerve fibres. One of the major risk factors for this disease is advancing age, being most prevalent in people over 40 years of age.1 Moreover, a study conducted in Pakistan reported a high prevalence of primary open angle glaucoma in individuals over the age of 50.3 While glaucoma is one of the leading causes of blindness, the risk of blindness posed may be profoundly diminished with early diagnosis; a study suggests a marked decrease in blindness due to glaucoma owing to early diagnoses.4

In Pakistan, however, health seeking behaviour is already suboptimal. Additionally, a significant lack of awareness about glaucoma has also been reported in Pakistan, specifically in populations over the age of 45,5 which is the age group at the greatest risk of development of glaucoma. Proper access to eye health has been associated with employment prospects and economic productivity, especially in developing countries like Pakistan,2 while loss of vision can lead to poor quality of life, especially in a country with very few options for meeting the needs of those who are visually impaired, leaving them with limited options for employment, hence forcing them to be dependent on others. This can collectively have a negative impact on a developing nation's economy.

Considering the aforementioned factors, it goes without saying how incredibly imperative it is to devise a thorough strategic plan for screening, prevention and diagnosis, coupled with necessary awareness programmes to curb and reduce the instances of glaucoma and glaucoma-associated complications as a whole.

 

Disclaimer: None to declare.

Conflict of Interest: None to declare.

Funding Sources: None to declare.

 

References

 

1.       Hassan B, Ahmed R, Li B, Noor A, Hassan ZU. A comprehensive study capturing vision loss burden in Pakistan (1990-2025): Findings from the Global Burden of Disease (GBD) 2017 study. PLoS One 2019; 14: e0216492.

2.       Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond. The Lancet Global Health Commission 2021; 9: E489-551

3.       Taqi U, Fasih U, Jafri SFA, Sheikh A. Frequency of primary open angle glaucoma in Abbasi Shaheed Hospital. J Pak Med Assoc 2011: 61: 778-81.

4.       Stein JD, Khawaja AP, Weizer JS. Glaucoma in Adults-Screening, Diagnosis, and Management. JAMA 2021; 325: 164-74.

5.       Rashid HI, Saif-ur-Rehman, Waheed I, Jabbar I, Tahir H, Sohail CS, et al. To Assess the Awareness about Glaucoma and Cataract in Patients (Aged 45 and Above) Presenting to Outpatient Department (OPD) of Jinnah Hospital Lahore, Pakistan. Ann Public Health Res 2018; 5: 1077.

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