In Nigeria, a Sightsavers-supported project is training teams of eye surgeons to use new methods to treat people with glaucoma.
As part of the Keep Sight project, in January a group of ophthalmologists were taught new ways to treat glaucoma patients, including newer ways to improve their skills in trabeculectomy, a glaucoma surgical procedure.
The training involved practical demonstrations and hands-on sessions at the University of Abuja training hospital. A team led by Professor Abdulkabir Ayanniyi and Dr Adunola Ogunro (the lead glaucoma trainer) operated on four patients who had been diagnosed with glaucoma.
One of the ophthalmologists who took part was Dr Ejayo Ume. “Because of the nature of the disease, we call it a ‘silent taker of sight’, so most patients come when it’s usually very advanced,” she explains.
“Glaucoma causes irreversible damage to the nerve that operates the eye. Once damage has occurred, we can’t reverse it. So, the treatment we give these patients is just to manage what vision they have left, so they maintain their vision for a very long period of time.”
The Keep Sight initiative, launched in 2019, aims to treat and prevent glaucoma in Nigeria and India. It’s funded by Allergan and run in partnership with the International Agency for the Prevention of Blindness (IAPB).
“In this part of the world, we don’t have that culture of going for routine early checks,” says Prof Ayanniyi. “So it’s very, very difficult to diagnose glaucoma except in[a few people who have family history, or maybe when they are checked at an eye facility for another condition entirely or routine examination.
“In the early stages, most patients will not have symptoms. So it’s one of the reasons why it is very difficult to diagnose.”
One of the patients to receive glaucoma surgery as part of the training was a 54-year-old man from Abuja, who noticed a problem with his vision in 2009.
“I feel happy [about having the surgery now] because at least it will reduce part of the problem for me,” he says. “From what I was told, after the surgery, I will be able to at least manage the problem and I can take care of it.”
Once patients have been referred for treatment, they can sometimes help to encourage others to seek treatment as well, as this patient did: “I called one of my cousins who informed me that yes, he had glaucoma. When I called him and told him [I was having surgery], he said he was the having the same problem, that he has gone for surgery and he is managing it.”
Dr Fatima Kyari, one of the Keep Sight trainers, is an ophthalmologist who focused on glaucoma as part of her PhD research. She highlights the importance of getting checked if you have a family member with the condition. “If a person has glaucoma, there is a high risk their parents, siblings or children may be affected,” she says. “So any person that has glaucoma should encourage those relatives to have their eyes checked as well.
“The patients don’t understand the disease, as they don’t get to see the symptoms early. So they come late. Then medicines are expensive, and people are reluctant to get surgery. Surgeons may also be reluctant to perform the surgery when the condition is very advanced.
“Unlike other conditions such as cataracts, it’s not a ‘wow’ thing. When you remove the cataracts, they wake up the following day and it’s like: ‘Wow, I can see.’ But glaucoma is not like that.”
Prof Ayanniyi explains that to improve the awareness of glaucoma, he needs support from the government, non-governmental organisations and society in general so people will get screened earlier.
“It’s possible for somebody or an individual with glaucoma to have near normal vision throughout their life,” he says. “If there is support, glaucoma should no longer be a blinding eye condition. I see a situation when glaucoma will no longer be causing blindness.”
“With more health education and awareness, patients can develop confidence to accept and adhere to treatment.”
Eye surgeon Fatima Kyari
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