Etiology of secondary glaucoma at university clinics in Munich and Nairobi

Abstract

Glaucoma is one of the most common blinding diseases worldwide. For early detection and treatment of this insidious ailment investigations of risk factors are necessary, most of which require extensive technically demanding and time consuming procedures. Basic information on risk factors for the development of glaucomatous damage is essential for diagnosis of glaucoma, for the identification of groups at risk, and for the planning of prevention and intervention programs. Epidemiological data on secondary glaucomas is especially scarce, while at the same time the strict distinction between primary and secondary glaucomas has been abandoned with changing pathophysiological rationale. We compared the distribution of the main causes of secondary glaucomas in the university eye clinics in Munich and Nairobi, with the aim of finding possible risk factors and obtaining basic information that might be used in preventive programs. We examined 150 patients in Munich and 132 in Nairobi in 1991 and 1992. In addition to tests of visual acuity and intraocular pressure, gonioscopy, ophthalmoscopic assessment of the optic disc and perimetry were performed. Eyes with intraocular pressures above 22 mmHg and a detectable causative condition were selected for the study. The average age of the patients in Munich was 65 years, and most of them presented with glaucoma caused by iris neovascularization (42%), followed by exfoliation syndrome (14%), intraocular inflammation (11%), trauma (10%) and preceding ocular surgery (9%). In Kenya patients were significantly younger, with an average age of 41 years. Here most glaucomas were posttraumatic (40%); 70% of these patients were aged under 30. Other causes were earlier operations (17%), inflammation (16%), lentogenous changes (10%) and neovascularizations (10%).(ABSTRACT TRUNCATED AT 250 WORDS)