Community Eye Health Journal (Sep 2006)
How to manage a patient with glaucoma in Asia
Abstract
IntroductionGlaucoma affects nearly 70 million people worldwide, of which nearly half are in Asia.1 Although more people are affected by primary open-angle glaucoma (POAG) than by primary angle-closure glaucoma (PACG), the latter is more common in Asians and carries a higher burden of morbidity. An estimated 13.6 million people will suffer from PACG in Asia by 2010, of which nearly 3.5 million will be bilaterally blind.2 Unlike cataract, visual loss from glaucoma is irreversible. The methods for management of POAG are similar to those described in the other sections of this issue, therefore we will concentrate on PACG in this article.Traditional definitions of PACG have emphasised the symptomatic aspect of the disease. However, only 25 per cent of PACG is symptomatic, therefore more modern definitions rely on objective evidence of damage to the trabecular meshwork and optic nerve.3 A diagnosis of glaucoma means that there is damage to the optic nerve as shown by changes in the optic disc and a characteristic visual field defect. One important distinction is that acute angle closure, where there is a sudden rise in intraocular pressure (IOP) causing pain and blurred vision, is not considered as glaucoma.As management pathways for PACG are different to that of POAG, accurate detection as well as treatment are important when dealing with glaucoma in Asia.
