Presented 0910hrs 10Jun2011 as the CJO Lecture in the Current Concepts I session: Canadian Ophthalmological Society 74th Annual Meeting, Vancouver, BC by Dr Colin Cook
Reference is to Foster (spoke last year at this meeting) and Quigley for his talk. Prevalence of glaucoma increasing due to aging of the population. Angle closure more likely to lead to blindness. ACG more common in Asia and in the Inuit population.
As for INCIDENCE data, which is needed to plan for our care needs, but much harder to do. The easier way to do that is to adapt the prevalence data using a mathematicla model. Incidence of blindness from glaucoma: lack of data. But we can say that the Black Uganda population, 0.04% annual incidence of visual loss from glaucoma.
Population based screening is inappropriate as no one set that is appropriate. We want to be efficient and effective, doing things right and doing the right things respectively, But if you are in certain regions of the world, you do not have the caregivers to be efficient or effective in these low income settings.
Case detection score developed based on Vision, VA has scoring up to 11. Additional testing with a field nurse for other parameters has 28 potential more points. Some sort of case detection score may be useful.
Access issues are also faced in developed countries and we can learn alot of things. Any comments for how to improve care in developed countries too? Further suggestion to look for RAPD as part of the screening.