STUDY ON PATTERN OF SECONDARY GLAUCOMA IN RURAL HOSPITAL

Introduction: Glaucoma is a chronic, progressive optic neuropathy leading to loss of visual function. It is the second most common cause of blindness.

Aim: To study the pattern of secondary glaucoma and to identify their known risk factors and its aetiology.

Methods: A observational, descriptive cross-sectional study was conducted at a tertiary care hospital in rural set-up. A total of 45 patients with raised IOP having suspected secondary glaucoma were evaluated. Evaluation was done on the basis of detailed history and clinical examination including visual acuity, anterior segment examination, intraocular pressure, gonioscopy and fundus evaluation.

Results: The mean age at presentation was 65.46±13.72 years with 60% (27) males and 40% (18) females. Diabetes mellitus was seen in 22.2% (10), long term steroid use in 2.22% (1). Out of 45 patients 46.66% (21) had lens induced glaucoma, 26.66% (12) had pseudoexfoliatory glaucoma, 2.22% (1) had steroid induced glaucoma, 2.22% (1) had pigmentary glaucoma, 35.56% (4) had neovascular glaucoma, 4.44% (2) had inflammatory glaucoma, 2.22% (1) had angle recession glaucoma, 4.44% (2) had pseudophakic glaucoma and 2.22% (1) had malignant glaucoma. The mean IOP was 42.75±9.98 mm Hg at the time of presentation. Vision was PL -ve in 8.88% (4), PL + and PR faulty in 15.55% (7), PL + PR + in 60% (27) and less than 6/36 in 15.55% (7). On funduscopy 13.32% (6) had glaucomatous optic atrophy, 6.66% (3) had advanced glaucomatous disc changes, 6.66% (3) had normal findings and in 73.26% (33) it was not visualized due to hazy media. Gonioscopy showed that 26.64% (12) had open angle out of which 2.22% (1) had pigmentation (sampaolesi’s line), 4.44% (2) had neovascularisation of the angle, 2.22% (1) had angle recession and in 66.6% (30) gonioscopy was not possible due to corneal edema and pain.

Conclusion: All 45 patients were evaluated clinically and it was found that secondary glaucoma was most common in 61-70 years with male predominance. The most common type was lens induced type followed by pseudoexfoliatory type.