Presentation of Primary Open Angle Glaucoma (POAG) at Lions Sight First Eye Hospital in Blantyre, Malawi

Objective
Primary open angle glaucoma (POAG) is the most common type of glaucoma in Africa. We carried out a study to determine the clinical presentation pattern of patients with primary open angle glaucoma (POAG) at a tertiary hospital in Malawi.
Design
A cross-sectional study
Setting
Lions Sight First Eye Hospital—a major referral and teaching state eye hospital in Blantyre, Malawi
Subjects
Study participants were newly diagnosed POAG patients at specialist eye clinic during study period.
Results
A total of 60 POAG patients were recruited into the study. The mean age was 58.7 years (SD= 16.6, range 18 - 86). There were more male (44, 73.3%) than female (16, 27.7%) patients. The majority of patients (73%) presented one year after onset of visual symptoms. Twenty-six patients (43%) had unilateral blindness (visual acuity < 3/60; WHO classification), while nine patients (15%) presented with bilateral blindness. A vertical cup-to-disc ratio (CDR) of 0.8 or worse was seen in 92 eyes (79%). The mean intraocular pressure (IOP) reading was 35.5 mmHg (SD 13.30). Of the thirty-three eyes that successfully underwent visual field analysis, very advanced defects were recorded in 12 eyes (36%).
Conclusion
This study demonstrates delayed presentation and male predominance among POAG patients at a tertiary eye hospital in Malawi. Glaucoma intervention programmes should aim at identifying patients with treatable glaucoma with particular attention to women.