ASSESSMENT OF KNOWLEDGE, AWARENESS ON GLAUCOMA AMONG GLAUCOMA PATIENTS & ITS IMPACT ON DAILY LIFE.

P.Nirmala Jyothi Pamu 1 and Chandana Priyanka.S 2 . 1. Associate professor, Ophthalmology, Andhra Medical College, Visakhapatam. 2. Junior Resident, Ophthalmology, Andhra medical college, Visakhaptnam. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 04 December 2018 Final Accepted: 06 January 2019 Published: February 2019


Aim:
To assess the knowledge, awareness on glaucoma and its impact on the quality of life of patients with glaucoma. Materials and method: A questionnaire was delivered to patients willing to take part,and have a regular visit to the ophthalmology department,250 patients who are diagnosed of having glaucoma and started on medical management with age between 40 -70 years were included in the study. Results: Among 250 patients who attended to the glaucoma department 58% were females and males were 42% with the mean age of 51.2 years (ranges40-70) of them. Among them literates were 32%, illiterates were 68%.82% patients in our study never heard about glaucoma before diagnosed as having glaucoma.65%of patients reported negative emotions, 85% were facing difficulties in daily activities due to visual problems,38% reported poor compliance to the treatment. Conclusion: Our study highlights that there is a need for improving the awarenesson this asymptomatic disease and reinforcement of knowledge and practice on proper instillation of eye drops among patients by counselling can help patients to adhere to management and follow up.
It is the second leading cause of world's irreversible blindness with 11million of these patients from India 1,2 . These blindness figures are expected to be doubled by 2020 3 . Several studies have estimated the awareness of this slowly progressive asymptomatic condition in southern India 4,5,6 . It largely remains underdiagnosed due to its asymptomatic nature and lack of awareness amongst people 7,8 .

ISSN: 2320-5407
Int. J. Adv. Res. 7(2), 374-378 375 Lack of awareness not only influences the timing of diagnosis but also the utilization of eye care services. The disease itself as well as its therapy has an impact on patient's quality of life. In the management of the patients with glaucoma, it has been recognised that it is important to take their whole life situation into consideration.
So the study is undertaken to understand the knowledge & awareness and impact of glaucoma on their life using a questionnaire which would help us to understand the gap and to have a holistic approach of the disease.

Aim:-
To assess the knowledge, awareness of glaucoma and its impact on the quality of life of patients with glaucoma.

Materials and Methodology:-
It is a hospital-basedcross-sectional study done in the outpatient department of ophthalmology at glaucoma department, 250 patients of either sex diagnosed as having glaucoma and on treatment were studied in addition being subjected to a detailed comprehensive eye examination and a specifically designed semi-structured questionnaire was used. Individuals with clinically significant impairment of visual functions other than glaucoma wereexcluded. After obtaining the consent from the patient to participate in the study a specifically designed semistructured questionnaire was used which was available in local language and reading assistance to illiterate was provided. The questionnaire included three domains -the first section pertained to awareness which comprised 5 questions and about knowledge 5 questions, 4 questions for assessing the quality of life in glaucoma patients with multiple options. One question about the satisfaction of the information given by the doctor in the clinic. Each questions has two options and the respondents has to tick the response of their choice. If they left unanswered it is assumed as they don't have knowledge regarding the disease aspect.

Results:-
Among 250 patients who attended to the glaucoma clinic females were 58% and males 42% with the mean age of 51.2 years (ranges40-70) of them. Among them literates were 32%, illiterates were 68%. Few of our patients gave expression of visual problems related to their disease, and 68% were satisfied with the information and care given.   82% patients in our study never heard about glaucoma before diagnosed, which coincides with the similar result in a study by Krishnaiah S et al 6 where a total of 61 % did not even know what glaucoma is. In study by Praveen et al stated only 8.3% were aware of glaucoma. In the present study those individuals with higher elementary education and with family history of glaucoma had better understanding about the disease and had a regular follow up. In a study by Satyamangalam.R 5 et al women and those with family those who were unaware and don't know the progression of disease had more visual problems and poor follow up. In the present study 39% of the patients who are on treatment are unaware that blindness due to glaucoma can be prevented. 70% are unaware of its familial predisposition. 68% are satisfied with the information and care given by the treating health personnel, 32% who are below 50 years showed more interest to know more about the disease and risk of going blind and other treatment modalities.
78% of the patients were able to answer that it is slow irreversible damage due to pressure effects on the nerve. 65%of patients reported negative emotions. The fear of going blind and anxious was more among middle-aged persons and females( 51%) which was also noticed by Tor Odberg 10 et al where about 89% of them had fear of becoming blind more among young individuals .85% were facing difficulties in daily activities due to visual problems like identifying persons, walkingstairs, reading which coincides with the study done by Tor Odberg et al 10 where the patients had faced difficulty in recognizing the persons, reading and climbing stairs.38% reported poor compliance for follow up and instillation of topical eye drops in those who were above 60 years and are dependent on help from others.
Limitations of the study:Small sample size, Questionnaire has its own limitations .

Conclusion:-
Our study highlights that there is a need for improving the awarenesson this asymptomatic disease among general public. This can be achieved by health education, media and health camps, screening. Reinforcement of knowledge and practice on proper instillation of eye drops among patients by counselling can help patients to adhere to management and follow up and reduce the national and global burden of blindness due to glaucoma. Holistic approach is needed to understand the nature and the progression of an asymptomatic disease like glaucoma and to halt its progression and help in improving the quality of life of patients who are affected with glaucoma.