Types of Glaucoma and recent trends applied in treatment: Observations from a Glaucoma Training Workshop in the Gambia

Abstract

To determine types of glaucoma seen and the recent trends applied in treatment, a retrospective non-comparative case-series study was conducted in the Eye Unit of the Royal Victoria Hospital, Banjul, The Gambia. The records of the 88 patients(145 eyes) seen during the glaucoma training workshop(organised by Prof.James Standefer, a clinical ophthalmologist from Minneapolis, U.S.A.) which held between 3rd and 14th of September, 2001, were analysed for types of glaucoma and treatment given. All but one patient who was a baby underwent the following tests: visual acuity measurement using the illiterate E-Chart with multiple optotypes; tonometry using the Schiotz tonometer with the 5.5g weight; oblique flashlight test; Van Herrick's estimation of the angle depth; pupillary reactions to light; Slitlamp biomicroscopy; gonioscopy using the 4-mirror pressure gonioprism; fundoscopy using the +78D Volk lens and confrontational visual field analysis. 27 eyes did not have definite glaucoma. Out of the remaining 118 eyes, 65(55.08%) had POAG;17(14.41%)ACG out of which 8 were CACG and 2 acute ACG. 8 eyes had pseudoexfoliation of the lens capsule with or without glaucoma. In the frail and elderly, guttae Timoptol 0.5% was given once daily. 27 eyes had trabeculectomy; all were with releasable sutures and intraoperative application of 5-Fluorouracil. 3 eyes had laser trabeculoplasty and 5, diode laser transscleral cyclophotocoagulation. POAG was the commonest type of glaucoma seen. Pseudoexfoliation of the lens capsule with or without glaucoma and ACG are not very rare in The Gambia. In the frail and elderly, guttae Timoptol 0.5% was given once daily and none at all in painless glaucoma-blind eyes. Trabeculectomy with releasable sutures and intraoperative application of 5-FU has a very satisfactory pressure-lowering effect. glaucoma; treatment; the Gambia.