Knowledge of Risk Factors of Glaucoma Blindness in Pre Clinical Pre-clinical Medical Students of Lautech Teaching Hospital
Chapter One
General Objective
To assess the knowledge of risk factors of glaucoma blindness among LAUTECH Pre-clinical medical students.
Specific Objectives
- To determine the knowledge of LAUTECH pre-clinical medical students of glaucoma blindness.
- To assess the attitude of LAUTECH pre-clinical medical students towards glaucoma blindness.
- To determine the influence of knowledge and attitude on knowledge of risk factors of blindness among LAUTECH pre-clinical medical students.
CHAPTER TWO
LITERATURE REVIEW
Introduction
This chapter conducts a thorough literature review in relation to the study’s goals. Knowledge of eye problems, perspective on glaucoma-related blindness, and risk factor awareness were the main topics.
Overview of visual impairment and blindness
According to a recent population-based study in Nigeria, glaucoma (19.4%) and cataract (54.8%) were the two main causes of blindness. Refractive error (44.4%) and cataract (42.2%) were the two leading causes of reported visual impairment. Blindness was 0.74% common, while severe impairment was 1.07% common (Wiafe, 2015). According to Nigeria’s demographic data, 290,000 persons are visually impaired and 200,000 are blind.
In a different clinic-based study conducted in Nigeria, the prevalence of vision impairment and blindness was 17.1% and 1.2%, respectively; however, once corrective eyewear was worn, those numbers fell to 6.7% and 0.75 percent, respectively (Budenz et al., 2012). indicating that uncorrected refractive error (URE) is a significant public health challenge and that refractive error (RE) is one of the most frequent ocular disorders (Naidoo et al., 2016).
PATHOPHYSIOLOGY OF GLAUCOMA
Aqueous humour overproduction or occlusion of the sclemnis canal or trabecular meshwork result in primary open-angle glaucoma, which raises intraocular pressure and harms the optic nerve. A persistent, slowly progressing, typically bilateral optic nerve neuropathy called glaucoma. Glaucoma that is left untreated eventually results in total blindness. About 10% of glaucoma patients develop unilateral or bilateral blindness. In relation to the intraocular pressure, the pathophysiology of glaucoma is a progressive loss of ganglion cells that results in visual field impairment (Chin & Regine, 2008).
RISK FACTORS FOR GLAUCOMA
Everyone, from young children to elderly people, is susceptible to glaucoma. Although glaucoma can be present at birth, it is more common in older adults. Glaucoma can affect young adults as well. Ageing, a family history of glaucoma, race and ethnicity, nearsightedness, high blood pressure, diabetes mellitus, and raised intraocular pressure are some of the known risk factors for glaucoma.
Most studies have noted a relationship between aging and primary open-angle glaucoma (POAG). According to evidence from study, glaucoma risk is highest for those between the ages of 40 and 80 (Honkanen & Nemesure, 2008). These findings are in line with the Meiktila Eye Study (Franzco & MD, 2007). In the univariate study, POAG was substantially correlated with increasing age (P=0.024), spherical equivalent (P=0.01), axial length (P0.023), and intraocular pressure (IOP; P0.001). Myopia of less than 0.5 D (P=0.049), advancing age, and IOP (P0.001) were found to be significant risk variables for POAG in the multivariate analysis.
In a Taijim investigation, Kawase and Yamamoto (2008) discovered a direct link between IOP and myopia. Another risk factor for glaucoma is family history. There is proof that having a family history of POAG increases risk (Kwon, Fingert, Kuehn & Alward, 2009). Open-angle glaucoma risk variables strongly correlate within families, and the patterns support the idea that these risk factors have genetic drivers. (Klein, Klein & Lee, 2004). Many cases of glaucoma have a variety of genes that have been suggested as potential causes. Early-onset forms of glaucoma, including as congenital glaucoma and glaucoma linked to pigment dispersion syndrome, are typically inherited as Mendelian-dominant or Mendelian-receiver features (Wiggs, 2007).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter describes the research design and methodology used to access the knowledge level, risk factors of glaucoma blindness among LAUTECH Pre-clinical medical students. The methodology and research design were informed by the objectives of the study. It entails the measurement of the variables in the research, sample and sampling design, data collection technique and ethical considerations.
Study Design
This study was a cross-sectional design utilizing quantitative methods.
Study population
The study was conducted among the LAUTECH Pre-clinical medical students on the Lagos main campus.
CHAPTER FOUR
RESULTS
Introduction
The chapter 4 shows findings of the study and they answer the objectives of the study. This section provides summary of the socio-demographic characteristics of the study participants, the participants reported health and ocular history, their family’s ocular and general health history, their knowledge, attitude and the knowledge of risk factors of among LAUTECH Pre-clinical medical students. Data was collected from October 2022 to January 2023.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
Conclusion
Majority of the respondents had good attitude towards glaucoma blindness and but demonstrated poor knowledge about eye conditions. Demographic factors that were found to influence level of knowledge among respondents included age and the college the students belonged to. Many of the students with increased level of knowledge were from the Teaching hospital. The college with the poorest level of knowledge among the respondents was the College of Humanities. Level of knowledge was also discovered to be high among respondents who have ever visited the eye clinic. Visit to the eye clinic influenced level of attitude of respondents. Factors that influenced attitude level included marital status of respondents and the increased number of times they had had their eyes checked.
Overall, the level of knowledge among respondents was found to be low and attitude was high. But awareness of glaucoma was high among participants, awareness for cataract 62.0% in this study.
Predictors of motivation to patronize glaucoma facility are affordability and expertise of professionals. The government must continually work on health financing to eliminate cost as a barrier to health care.
The significant level of knowledge among different college is possibly because most students in the health sciences have health background, and may have had information of glaucoma, cataract and refractive during school or during their line of duty.
Good level of knowledge on glaucoma, cataract and refractive error, leads to good attitude towards glaucoma accounting for good knowledge of risk factors of and vice versa when other factors are controlled, knowledge remained strongly significant statistically implying when one has knowledge about eye conditions they are 2.34 times likely to have good attitude and will have good practice. Despite other population studies attributed high level knowledge of eye diseases among people with high level of education, but the outcome of this study found otherwise, therefore the assumption that people with high level of education have good knowledge is not reliable.
Recommendations
The top most motivation to patronize an glaucoma facility were cost of services and expertise of health care personnel. Majority of participants have the National Health Insurance Scheme (NHIS) cards. It imply the government must continually work on health financing to eliminate cost as a barrier to glaucoma blindness.
Pre-clinical medical students who ever checked their eyes remember checking their visual acuity (read letters from a chat), but most of them did not check their eye pressure, or had done fundus examination (looked into the eyes), this calls for the need to create awareness among health professionals to provide comprehensive glaucoma for all persons that visit the eye facility especially the at risk group. There is also the need for further research into the satisfaction of glaucoma services among people with high level of education in Nigeria.
In addition to community outreaches, the poor level of knowledge among pre-clinical medical students suggests rigorous health education and information dissemination activities that must target university community in Nigeria especially the pre-clinical medical students to ensure preventive glaucoma.
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