South East has highest rate of glaucoma in Nigeria

Glaucoma• Pfizer partners with Eye Hospitals to raise awareness

The Federal Government has been asked to ease the duties and taxes on drugs for the treatment of eye conditions especially glaucoma, which is a life long ailment.

The Chief Consultant Ophthalmologist at The Eye Specialists Hospital (TESH) Enugu State, Dr. Nkiru Kizor-Akaraiwe, who made the call at the weekend as the hospital rounded off activities to mark the World Glaucoma Week (March 6-12) disclosed that the South East has the highest prevalence of glaucoma in Nigeria while she hailed the growing awareness and knowledge of glaucoma in the area.

The activities of the World Glaucoma Week were sponsored by Pfizer Pharmaceuticals Nigeria.

As hundreds of people lined up and others seated under canopies for the free glaucoma screening, an activity to conclude the World Glaucoma Week, Kizor-Akaraiwe said that it is a significant development that more institutions, corporate bodies, non governmental organisations, and others engaged in the management and caring for glaucoma patients, are more involved in this year’s activities.

According to her, “the awareness of glaucoma generally is poor nationwide. At one time, the figure was 90 per cent non-awareness. In Enugu State for example, since 2007 or thereabouts, we have been creating awareness and so, the awareness level has greatly increased in this environment because of the approach and strategy. We used radio and television programs, and the churches for public enlightenment. Initially, a local survey showed that awareness and knowledge of glaucoma might have been about 20 per cent. Recently, about last year when we checked again, we recorded about 60 per cent awareness and knowledge of glaucoma. That’s a significant improvement. We see that more people are getting involved and the result is that it is common today to see people walk into the clinic to request for eye checks. It was not the case before.”

Calling for more attention to glaucoma, the leading cause of irreversible blindness, she said, “unfortunately, it is usually symptomless until very late in the disease process, and it is almost blinding the eyes before the person becomes aware with blurring of vision and other such symptoms that might now bring them to the hospital. It is therefore only through routine checks that glaucoma can be detected. The free screening during the World Glaucoma Week, is one way to raise that awareness and let people know if they have glaucoma or not.”

As she noted the need for support from institutions, Kizor- Akaraiwe explained that, “a lot of times we put a lot of things for government to do but I don’t think it is in government’s place to do some of those things. We need government assistance in reducing tax and duties on drugs for treatment of the eyes and glaucoma that is a life long thing so that the cost be bearable for the patient and to be able to maintain their medication.”

As she dismissed any insinuation linking the high prevalence of glaucoma in the South East, to diet or environment, she said, “nothing has been found in that direction. The only thing that has been found is that there is a familiar thing to it. For example, if it is detected in a family, it is more likely it will be found in any of the other members of the family than in a family it has not been found. This only confirms that there is a genetic component to it.

“Generally, glaucoma is worse in Africa, worse among black Africans, and in Nigeria, the most populous black nation, we have a high incidence of glaucoma. And according to the last national survey on the population of glaucoma patients, South East has the highest prevalence of glaucoma blindness in Nigeria. It is uncertain yet why that is so and we are doing research to find that. There are no known causes yet.” She however noted that: “When you are a black, an African, then you are Igbo, aged 35 and above, these are mainly risk factors to developing glaucoma.”

The consultant ophthalmologist noted that perhaps what was more worrisome is that, “the management of glaucoma is for life. And any medical condition you have to care for life cannot be easy. Notwithstanding the option of treatment, whether with drugs, laser or surgery you still manage it for life. Most patients need three or four different drugs to have their pressures under control. Sustaining that (financially) is not cheap.

“Then there is the challenge of compliance and of fake drugs. There is the usual practice of patients starting and stopping taking their drugs with the intention of starting later. Gradually, they intend to lose their vision. But there are those who are on medication but they don’t go to check their eyes. The truth is that the drugs that were effective for the condition today might lose their efficacy tomorrow and the patient never knows when the drug has lost its efficacy. But this can be seen during routine checks.

“The World Health Organisation (WHO) has actually advised that patients in developing countries where they have challenges of meeting up with the cost of therapy and the genuineness of medications, should elect for surgery as primary treatment. Gradually, our people are beginning to accept surgery. Indigent patients with significant cases of glaucoma are advised to do surgery because it is cheaper in the long run.”

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