Aile Hekimliği Polikliniğine Başvuran 40 Yaş Üzeri Hastalarda Glokom Farkındalığı ve Sıklığı

Abstract

Amaç: Glokomun semptom vermemesi, görme kaybı oluşana dek tanı konamamasına ve tedavide geç kalınmasına yol açmaktadır. Bu durumun en önemli nedeni farkındalığın düşük olmasıdır. Bu çalışmada, Aile hekimliği polikliniğine herhangi bir sebeple başvuran 40 yaş üzeri hastalarda glokom farkındalığını ve sıklığını belirlemek amaçlandı. Gereç ve Yöntem: Kesitsel nitelikteki çalışmaya, Haziran 2019-Ekim 2019 tarihleri arasında herhangi bir sebeple Aile Hekimliği polikliniğine başvuran 40 yaş üzeri hastalar dahil edildi. Katılımcılara, sosyo-demografik ve klinik özelliklerini, glokom farkındalığını değerlendirmek için 15 sorudan oluşan bir anket uygulandı.Hastaların göz polikliniğinde, aynı uzman doktor tarafından refraksiyon kusurları, göz içi basıncı(GİB), santral kornea kalınlığı(SKK) ölçüldü ve biyomikroskopik muayeneleri yapıldı. Glokom tespit edilen ve edilmeyen hastalar risk faktörleri ve farkındalık durumu açısından değerlendirildi. Bulgular: Çalışmaya dahil edilen 206 hastanın %62,6'sı kadın, %37,4'ü erkekti. Yaş ortalaması 58,3±10,0 yıldı. Katılımcıların %6,3'ünde glokom tespit edildi. Glokom muayenesi olmadığını belirtenlerin %4,8'inde, glokom muayenesi olduğunu belirtenlerin %22,2'sinde glokom tespit edildi. Hastaların %90,3'ü glokomun ne olduğunu ve belirtilerin bilmediğini,%91,3'ü glokom muayenesi olmadığını belirtti. Glokomun ne olduğunu bilenlerin %57,9'u göz doktorundan öğrendiğini belirtti. Sigara kullanımı açısından gruplar arasında anlamlı farklılık saptandı (p=0,02). Glokomu olan 13 hastanın hiç biri sigara içmiyordu. Glokom muayenesi olduğunu belirtenlerde, muayene olmayanlara göre, glokomun ne olduğunu ve belirtilerini bilenlerde bilmeyenlere göre glokom sıklığı anlamlı olarak daha fazla bulundu (sırasıyla, p=0,01, p=0,001 ve p=0,004). Yaş, ailede glokom öyküsü ve glokom muayenesi olma durumu ile glokom farkındalığı arasında anlamlı ilişki tespit edildi (sırasıyla, p=0.01, p=0.01 ve p=0.001). Sonuç:Görme kaybına neden olan, ancak erken tanı ve tedavi ile kontrol altına alınabilen glokom için toplumda farkındalığı artırma ve hastalık kontrolünde göz hekimi ve aile hekimlerinin bilgilendirme ve düzenli takipleri en önemli girişimdir. 

Keywords

• glokom
• farkındalık
• sıklık

Awareness and Frequency of Glaucoma in Patients Over 40 Years of Age Admitted to the Family Medicine Outpatient Clinic

Abstract

Aim: As the glaucoma has no symptom it causes delay in diagnosis and treatment until vision loss occurs. The most important reason for this situation is the low awareness. In this study, it was aimed to determine glaucoma awareness and incidence in patients over 40 years of age who attended to the family medicine outpatient clinic for any reason. Materials and Methods: Patients over 40 years of age who attended to the family medicine outpatient clinic for any reason between June 2019-October 2019 were included in the cross-sectional study. A questionnaire consisting of 15 questions was applied to the participants to evaluate their socio-demographic and clinical characteristics and glaucoma awareness. Refractive errors, intra ocular pressure (IOP), central corneal thickness (CCT) of the patients were measured in the ophthalmology clinic and their biomicroscopic examinations were performed by the same ophthalmologist. Patients with and without glaucoma were evaluated in terms of risk factors and awareness, and awareness status in terms of related factors. Results: Of the 206 patients included in the study, 62.6% were female and 37.4% were male. The mean age was 58.3±10.0 years. Glaucoma was detected in 6.3% of the participants. Glaucoma was detected in 4.8% of those who stated that they had no glaucoma examination, and 22.2% of those who stated that they had glaucoma examination. 90.3% of the patients stated that they did not know what is and what are the symptoms of glaucoma, 91.3% of them did not have glaucoma examination. 57.9% of those who know what glaucoma is, stated that they have learned it from the ophthalmologist. Significant difference was determined between groups in terms of smoking (p=0,02). None of the 13 patients with glaucoma were smoking. The frequency of glaucoma was significantly higher in those who stated that they had a glaucoma examination than those who did not, those who know what glaucoma is and its symptoms than those who did not know (p=0,01, p=0,001, p=0,004, respectively). A significant correlation was found between age, family history of glaucoma and glaucoma examination and glaucoma awareness (p=0.01, p=0.01, p=0.001, respectively). Conclusion: In increasing awareness and disease control for glaucoma, which causes irreversible vision loss but can be controlled with early diagnosis and treatment, the information and regular follow-up of eye and family physicians is the most important attempt.

Keywords

• Glaucoma
• awreness
• prevalance

References

1. 1. Casson RJ, Chidlow G, Wood JP, Crowston JG, Goldberg I. Definition of glaucoma: clinical and experimental concepts. ClinExpOphthalmol2012;40:341-349.
2. 2. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol 1996;80: 389-393.
3. 3. Mukesh BN, McCary CA, Raitij L, Taylor HR. Five year incidence of open angle glaucoma, the visual impairment Project glaucoma. Ophthalmology2002; 109: 1047-1051.
4. 4. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology.2014;121:2081-90.
5. 5. Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 2002; 86:238-242.
6. 6. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA2014; 311:1901-1911.
7. 7. Gogate P, Deshpande R, Chelerkar V, et al. Is glaucoma blindness a disease of deprivation and ignorance? A case-control study for late presentation of glaucoma in India. Indian J Ophthalmol2011;59:29-35.
8. 8. Fraser S, Bunce C, Wormald R. Retrospective analysis of risk factors for late presentation of chronic glaucoma. Br J Ophthalmol1999;83:24-28.

9. 9. Mason RP, Kosoko O, Wilson MR, et al. National survey of the prevalence and risk factors of glaucoma in St. Lucia, West Indies. Part I. Prevalence findings. Ophthalmology1989;96(9):1363-8.
10. 10. Friedman DS, Wolfs RCW, O’Colmain BJ, et al. Prevalence of open-angle glaucoma among adults in the United States. ArchOphthalmol 2004;122:532–538.
11. 11. Kyari F, Entekume G, Rabiu M, et al. Nigeria National Blindness and Visual Impairment Study Group. A Population-based survey of the prevalence and types of Glaucoma in Nigeria: results from the Nigeria national blindness and visual impairment survey. BMC Ophthalmol2015;15:176.
12. 12. S. Al Obeidan A, Dewedar A, Osman EA, Mousa A. The profile of glaucoma in a Tertiary Ophthalmic University Center in Riyadh SaudiArabia. SaudiJournal of Ophthalmology 2011;25(4):373–379.
13. 13. Krishnaiah S, Kovai V, Srinivas M, Shamanna BR, Rao GN, Thomas R. Awareness of Glaucoma in the Rural Population of Southern India. Indian Journal of Ophthalmology2005;53:205-208.
14. 14. Chaitra P, Laxman D, Jayshree P, Madhuri P, Puneet SS. Evaluation of the awareness on glaucoma in a rural eye camp in North Karnataka, India. J ClinDiagnRes 2012;6(7):1226–8.
15. 15. World Health Organization (WHO). Vision 2020 Priority Eye Diseases. https://www.iapb.org/global-initiatives/vision-2020/what-is-vision-2020/erişim 25.03.2020.
16. 16. Kizor-Akaraiwe NN, Monye HI, Okeke S. Awareness and knowledge about glaucoma and proportion of people with glaucoma in an urban outreach programme in Southeast Nigeria. BMJ Open Ophth 2017;1:e000018. doi:10.1136/bmjophth-2016-000018.
17. 17. Alemu DS, ,Gudeta AD, Gebreselassie KL. Awareness and knowledge of glaucoma and associated factors among adults: a cross sectional study in Gondar Town, Northwest Ethiopia. BMC Ophthalmology 2017;17:154.
18. 18. Tenkir A, Solomon B, Deribew A. Glaucoma awareness among people attending ophthalmic outreach services in Southwestern Ethiopia. BMC Ophthalmology2010;10:17.
19. 19. Krishnaiah S, Kovai V, Srinivas M, et al. Awareness of Glaucoma in the Rural Population of Southern India. Indian J Ophthalmol2005;53:205-208.
20. 20. Rewri P, Kakkar M. Awareness, knowledge, and practice: a survey of glaucoma in north Indian rural residents. Indian Journal of Ophthalmology 2014;62(4): 482–486.
21. 21. Ntim-Amponsah CT, Amoaku Winfried MK, Ofosu-Amaah S. Awareness and Knowledge of Glaucoma and other Diseases Associated with Blindness in a Ghanaian Community. Nigerian J Ophthalmol 2004;12(2):50-54.
22. 22. Al Rashed WA, Bin Abdulrahman AK, Zarban AA et al. Public Awareness regarding Common Eye Diseases among Saudi Adults in Riyadh City: A Quantitative Study. HindawiJournal of Ophthalmology2017;Article ID 9080791 https://doi.org/10.1155/2017/9080791.
23. 23. Gasch AT, Wang P, Pasquale LR. Determinants of glaucoma awareness in a general eye clinic. Ophthalmology 2000;107(2):303-8.
24. 24. Celebı ARC. Knowledge and Awareness of Glaucoma in Subjects with Glaucoma and their Normal First-Degree Relatives. MedHypothesisDiscovInnovOphthalmol. 2018, 7(1):40-47.
25. 25. Durowade KA, Salaudeen AG, Omotosho IM, et al. Knowledge and Risk Factors for Glaucoma among Adults in a Rural Community of Kwara State, North-Central Nigeria.TAF PrevMedBull 2014,13(5):375-380.
26. 26. Pfeiffer N, Krieglstein GK, Stegan W: Knowledge about glaucoma in the unselected population: a German survey. J Glaucoma 2002,11:458-63.
27. 27. Mansouri K, Orgül S, Meier-Gibbons F, Mermoud A: Awareness about glaucoma and related eye health attitudes in Switzerland: A survey of the general public. Ophthalmologica 2006,220:101-8.
28. 28. Landers JA, Franzco IG, Graham SL: Factors affecting awareness and knowledge of glaucoma among patients presenting to an urban emergency department. Clin Experiment Ophthalmol 2002, 30:104-9.
29. 29. McNaught AI, Allen JG, Healey DL, et al. Accuracy and implications of a reported family history of glaucoma: experience from the Glaucoma Inheritance Study in Tasmania. ArchOphthalmol. 2000,118(7):900-4.
30. 30. Deokule S, Sadiq S, Shah S. Chronico penangle glaucoma: patient awareness of the nature of the disease, topical medication, compliance and the prevalence of systemic symptoms. OphthalmicPhysiolOpt. 2004,24(1):9-15.