Eye Care Practices, Knowledge, and Attitude of Glaucoma Patients at Community Eye Outreach Screening in Nigeria

BACKGROUND: Community eye outreach (CEO) screening is an important model which has been widely employed to detect eye conditions such as cataract and glaucoma in high-risk groups. There is a dearth of data on the eye care practices of glaucoma patients identified using this model in South West Nigeria. OBJECTIVES: The aim of this article is to assess the eye care practices, knowledge, and attitudes of glaucoma patients/suspects identified at CEO screenings in Nigeria. DESIGN OF THE STUDY: This was a mixed method study with quantitative and qualitative approaches. SETTING IN WHICH THE STUDY TOOK PLACE: The study was carried out at 24 outreach screening centres in communities in Oyo and Osun states. MATERIALS AND METHODS: The quantitative component of this study was a cross-sectional survey of patients with suspected glaucoma identified at routine CEO in South West Nigeria. Surveys were administered by trained personnel and gathered information on knowledge and attitudes towards glaucoma. The qualitative component consisted of structured interviews with providers to assess their knowledge and perspectives of glaucoma patients’ attitudes and behaviours. RESULTS: A total of 1881 patients were screened at 24 outreach screenings in South West Nigeria, among which 120 glaucoma cases/suspects were identified. Fifty-six (46.7%) of the glaucoma patients were aware of glaucoma, but only 39 (32.5%) patients could answer at least one knowledge question correctly. Predictors of awareness of glaucoma were minimum of secondary school education [adjusted odds ratio (OR) 8.76; 95% confidence interval (CI) 3.18–24.13] and having had an eye check-up in the past (adjusted OR 5.87; 95% CI 1.92 – 17.92). Patients said cost and ‘not knowing the disease was serious’ were reasons for not following up at the main hospital. Health workers interviewed said that cost and poor knowledge were the main reasons glaucoma patients frequently attended free outreach screening events rather than seeking definitive care. CONCLUSION: Although CEO screenings improve access to eye care, provision of appropriate health education programs and strengthening of the health insurance scheme are needed to improve its impact in glaucoma care.