Late Presentation of Advanced Glaucoma Patients; Missed Opportunities for Diagnosis

Abstract

Objective: This study aimed to determine the proportion of late glaucoma presenting patients who have had previous contact with a primary eye health worker prior to presentation.
Methods: A systematic review and analysis was performed on ten studies with a total of 47,367 study participants identified meeting the inclusion and exclusion criteria. A meta- analysis of proportions was conducted on the late presenting glaucoma patients as well as the proportion of those that had previous contact with a primary eye care worker prior to diagnosis. We combined a narrative synthesis and quantitative (statistical pooling) approach for the synthesis of the extracted studies’ information.
Results: The pooled proportion of late presenting glaucoma patients was 0.325 (95% CI 0.178 -0.493). Out of all the late presenting glaucoma patients, n=2967, 96% (CI 0.85- 1.00) had previous contact with a primary eye health worker. The commonest type of primary eye health care workers identified were optometrists, general practitioners, ophthalmic nurses and technicians.
Conclusion: Out of all the late presenting glaucoma patients, a high number have previously been referred by a primary eye care worker. This represents a huge opportunity for directing effort at primary eye care level to identify and appropriately refer glaucoma patients for timely and definitive care.