Pattern of presentation and visual outcome of glaucoma in a tertiary hospital, Makurdi, Nigeria

Background: About 15% of blindness in Africa is due to glaucoma. The Nigerian National Blindness and Visual Impairment Survey found that glaucoma accounted for 16.7% of blindness with regional variations. The purpose of the study was to find the regional pattern of presentation and visual outcome to implement preventive measures. Methods: This was a descriptive retrospective study of new patients who presented to the eye clinic of Benue State University Teaching Hospital, Makurdi and were diagnosed of glaucoma. Results: In this study, 795 consecutive new patients who fulfilled the diagnostic criteria for glaucoma were included. Their mean age was 45.5 ± 18.3. There were 450 (56.6%) males. More patients presented in the fourth and fifth decade of life (n = 299, 37.6%). Primary open-angle glaucoma (inclusive of juvenile open-angle glaucoma, n =595, 74.8%, and normal tension glaucoma, n = 8, 1.0%) accounted for a total of 603 (75.8%). There were 145 (18.2%) glaucoma suspects, 23 (2.9%) primary angle-closure glaucoma, 20 (2.5%) secondary glaucoma, and four cases of congenital glaucoma. Vertical cup-to-disc ratio of ≥0.9 was in 634 (39.9%) of eyes; 274 (34.4%) were bilateral, and were all considered to have severe, advanced or end-stage glaucoma. About 203 (25.5%) had discs asymmetry of ≥0.2. About 355 (22.3%) patients’ eyes were blind: 95 (11.9%) bilateral and 165 (20.8%) uniocular. Conclusion: Open-angle glaucoma was most common, and patients presented at a young age with severe eye disease, visual impairment, and blindness.