Visual disability due to glaukoma according to the data of the medical and social examination of the city of Almaty

Abstract

Glaucoma is a leading cause of irreversible blindness and visual impairment. Preventing of amblyopia and blindness can be a cost-effective intervention by health services and primary health- social care services. According to A.P. Nesterov (2008), the term 'glaucoma' encompasses a large group of eye diseases with a predominantly chronic course and serious prognosis. Despite the fact that in Kazakhstan modern achievements of science and technology of glaucoma are developed and introduced into practical healthcare the number of patients blinded due to glaucoma does not decrease. Aim. To carry out an analysis of data on visual impairment due to glaucoma in Almaty for three years (2016 - 2018). Material and methods. The data of primary visual impairment of Almaty city population of according to MSE 2016 - 2018 were studied. In 2016, 204 out of 948 primary visually impaired patients were diagnosed with glaucoma, in 2017 respectively out of 1331 patients 279 were disabled, and in 2018 256 out of 1018 disabled patients were diagnosed with glaucoma. A total of 739 disabled patients were analysed over three years. Results and discussion. In comparative analysis of data by disability group, it was found that primary open-angle glaucoma was the main cause of disability during the last years studied. Consequently, the vision of the better seeing eye ranged from zero to 0.04 with optimal vision correction. Moreover, the proportion of group one disability gradually increased from 68.7% in 2016 to 86.8% in 2018, while group two data, on the contrary, decreased from 80.7% to 67.3% (terminal stage from 89.5% to 59.1%); group three figures were 65.0 to 71.2% and 76.3% to 80.5% respectively. The increase in the group III disabilities was slow (from 65.0% to 71.2%). The analysis of disability groups over the years under study has shown that the leading cause of disability is a primary open-angle glaucoma, followed by primary closed-angle, secondary and congenital glaucoma. Moreover congenital glaucoma has been reported since 2017 with a decreasing trend (3.2% to 1.2%). Conclusion. Timely detection and observation in dynamics, regular supportive therapy in patients with primary glaucoma regardless of the type and stage of the disease (except for the terminal stage), treatment of existing general, especially vascular disease at the place of residence at least twice a year would contribute to preserving of visual functions and decreasing the number of the visually impaired people. Key words: glaucoma, open-angle, closed-angle, secondary, congenital, disability groups, visual impairment.