Cross-sectional Survey to Determine the Awareness and Uptake of Glaucoma Surgery

Introduction : This study aimed to determine the awareness and uptake of surgery as a treatment option in patients with glaucoma on medical treatment. Methods : A cross-sectional survey was conducted among consenting patients with primary glaucoma who were on medical treatment. The survey was conducted in two eye care facilities (government-owned and private). After responding to a questionnaire, patients had ocular examinations, including visual acuity, anterior/posterior segment examinations, gonioscopy and central visual field testing. Information was obtained on the patients’ awareness of a surgical option, and reasons for non-uptake among those offered surgery were recorded. Logistic regression analysis was used to identify possible predictors of awareness of glaucoma. Results : Across both facilities, 299 patients with glaucoma with a mean age of 63.9 years participated in this study. There were 167 (55.9%) male and 132 (44.1%) female participants. Two hundred and sixty-seven (89.3%) had a formal education, and of the 169 evaluated for visual fields in the worse eye, 129 (76.3%) had severe (advanced) glaucoma. Only 79 (26.4%) of the participants were aware of surgery as a treatment option for glaucoma. The multivariate analysis found that female patients, patients from the private eye care facility and patients with primary angle closure glaucoma patients were more likely to be aware of glaucoma surgery than male patients, patients from the government-owned eye care facility and patients with primary open-angle glaucoma. Patients with primary angle closure glaucoma were more likely to be aware of glaucoma surgery than those with primary open-angle glaucoma. Cost was identified as the major barrier to the uptake of glaucoma surgery when it was recommended, followed by fear of blindness. Age, level of education and severity of disease had no statistical relationship to awareness of glaucoma surgery. Conclusion : Incorporating routine glaucoma education and counselling into glaucoma care protocols will likely improve awareness of glaucoma surgery as a treatment option.