Tackling Africa’s Glaucoma Burden
Medical and Surgical Strategies for Glaucoma Care in Africa
In his talk, Dr. Dan Kiage outlined the distinct challenges for glaucoma management in Africa given the high disease prevalence and low resources in the region. He then described the different strategies and initiatives that have been instituted in order to improve and standardize glaucoma care.
These include development of a practical toolkit for glaucoma management in Sub-Saharan Africa, fellowship training in glaucoma, reduction of costs and increasing the access and availability to glaucoma drainage devices and lasers.
The WGA’s Commitment to Glaucoma Care in Africa
Prof. Neeru Gupta spoke of the role and commitment of the World Glaucoma Association (WGA) in supporting the educational needs and training of ophthalmologists in Africa, specifically the WGA Fellowship Program which was instituted in 2016 in collaboration with the International Council of Ophthalmology (ICO).
The fellowship program is designed to facilitate ophthalmologists from developing countries to improve their practical skills and broaden their perspectives of ophthalmology and glaucoma.
Glaucoma – The Size and Weight of the Problem in Sub-Saharan Africa
Dr. Olusola Olawoye discussed the problems and consequences of glaucoma in Africa including the enormous disease burden, peculiarities of the disease and presentation, financial constraints and the lack of resources for effective management.
She then described the various measures that have been introduced in order to tackle the problems such as development of a toolkit for glaucoma management, initiation of several studies related to glaucoma management, engaging in genetic studies to identify novel susceptible loci, and improving glaucoma specific training via international fellowships and national ophthalmology societies.
How is Glaucoma in African Patients Uniquely Different?
Dr. Nkiru Kizor-Akaraiwe enumerated the distinct characteristics of glaucoma in African patients. In addition to an earlier age at onset and a more aggressive disease course, the patients have a relatively larger optic disc with smaller neuro-retinal rim and thinner RNFL.
In terms of treatment, topical medications have been found to have lesser efficacy compared to other ethnic groups, laser procedures although a more acceptable option are not easily available, and surgical interventions have a poorer acceptance rate.
2021 ICO-World Glaucoma Associations Fellows Speak Up About Challenges They Face
Dr. Yaseen Siddig Ahmed described the challenges he faced in the Northern State Hospital in Sudan such as the paucity of glaucoma-specific equipment for diagnosis and management, late disease presentation either due to poor access or lack of awareness, poor compliance to medications either due to unaffordability or unavailability, poor acceptance for surgery as well as lack of glaucoma trained ophthalmologists.
Dr. Kintoki Makela Guyguy from the Democratic Republic of Congo also reiterated the lack of glaucoma equipment, lack of awareness of the disease process and therapy, poor patient compliance and scarcity of sub-specialty trained ophthalmologists.
Dr. Aisha Sheriff Kalambe from Nigeria also stated the lack of awareness, trained manpower, and, equipment; as well as high costs and poor availability of medical and laser treatments as some of the challenges faced.
In addition to enumerating the challenges faced, Dr. Evelia Marole specifically highlighted the huge problem of a very low ophthalmologist to population ratio in Mozambique.
Dr. Oladele Arokoyo and Dr. Chinasa Nnubia both from Nigeria also listed late disease presentation, limited resources, financial constraints, poor compliance and access to care, and poor acceptance for surgical interventions as some of the challenges encountered.
Dr. Diane Sonassa from the Republic of Guinea also mentioned poor access to care, awareness, lack of trained manpower, and lack of equipment as the challenges faced.