Incidence of Open Angle Glaucoma among Patients with Pseudoexfoliation Syndrome in a Tertiary Eye Care Centre in South India - A Cross Sectional Study

Abstract

BACKGROUND Open angle glaucoma forms a major proportion of glaucomas which is a leading cause of irreversible blindness worldwide. Anatomical variations in ocular structures and consequent secondary open angle glaucoma occurs in significant number of patients afflicted with pseudoexfoliation syndrome. Hence, a detailed workup and identification of glaucoma and appropriate management is essential to prevent further visual loss. We wanted to evaluate the incidence of open angle glaucoma among patients having pseudo exfoliation syndrome at Regional Institute of Ophthalmology, Trivandrum, Kerala. METHODS A cross sectional study comprising 142 individuals with pseudo exfoliation syndrome was conducted in Regional Institute of Ophthalmology, Trivandrum, Kerala, over a period of one year. Sociodemographic variables were collected through structured interviewer administered questionnaire followed by detailed ocular work up and visual field analysis. Data was analysed using Statistical Package for Social Sciences, SPSS 16. RESULTS Among 142 subjects, 70.4 % were males and 29.6 % were females. The mean age of participants was 65 years. In studied population, 83.1 % represented rural population. Incidence of open angle glaucoma among studied population with pseudoexfoliation was 10.56 % (95 % confidence interval; 5.50 % - 15.61 %). No case of normal tension glaucoma was identified during the study period. 29.57 % of subjects showed bilateral pseudoexfoliation. But among patients with pseudoexfoliation (PEX) glaucoma, 78.9 % had bilateral disease. Mean intra ocular pressure in eyes with PEX glaucoma was 27.38 ± 5.75 mm Hg and in PEX eyes without glaucoma was 23.20 ± 1.6 mmHg. Pupillary dilatation was observed to be less than the normal eyes and was 5.62 mm. 4 % of eyes with PEX had some form of zonulopathy. CONCLUSIONS Hospital based incidence of open angle glaucoma among patients with pseudo exfoliation is 10.56 %. KEYWORDS Pseudoexfoliation, Open Angle Glaucoma, Incidence, Intraocular Pressure, Gonioscopy