Dr Vikas Shankar has found that in the diabetic population with OAG, the optic nerve damage occurs at a lower intraocular pressure in comparison with the non-diabetic OAG population and asks: does screening hold the key?
Our clinical examination included measurement of refraction and intraocular pressure (IOP), gonioscopy and disc assessment. Those who were suspected or diagnosed glaucomatous were admitted as inpatients for further 24-hour phasing of IOPs. Automated visual field1 24-2 along with optic disc assessment with photograph by a fundus camera were also carried out. Following these examinations, patients with a definitive diagnosis of OAG were included in the study. Patients were excluded if the media remained hazy, with non-visualization of the disc or if the patient was not co-operative with the visual field parameters.
What we found
The male:female ratio of the total sample size was 5937:5550 (male, 51.7%; female, 48.3%). Of the primary open angle glaucoma (POAG) patients with refractive error, 30.4% were seen to have myopia in the right eye and 32.1% in the left eye; 35% recorded hypermetropia in the right eye and 33% in the left eye. The degree of hypermetropia was usually in the lower range. Myopia appears to have a correlation to OAG, which was present in 4.2% of eyes with low myopia and 4.4% of eyes with moderate-to-high myopia, compared with 1.5% of eyes without myopia.