To Study Prevalance of Glaucoma In Diabetic Patients

Abstract

Introduction: Glaucoma is the second most prevalent cause of blindness, according to WHO figures1. Glaucoma affects around 12 million individuals in India, with the majority of cases being undetected. It is a quiet thief of eyesight 2 because it is asymptomatic until it has progressed to a late stage3. When a patient appears with visual impairment to an eye clinic, the condition is usually advanced, and the vision loss is irreversible4. One of the risk factors for primary open angle glaucoma is diabetes. Diabetic optic discs have a lower threshold for intra ocular pressure than normal people's optic discs, making them more susceptible to glaucomatous alterations. In Humphry automated perimetry, visual field defects are only detectable when up to 40 percent of the retinal nerve fibers have been destroyed. This is especially essential in diabetic individuals who are at an increased risk of developing diabetic retinopathy, which will further impair visual acuity. As a result, it is recommended that all diabetic patients to be screened to detect POAG at an early stage, even if there are no visual symptoms. As a result, the goal of our research is to determine the prevalence of glaucoma in diabetics, as well as to help patients by minimizing the disease's progression and complications through early detection and treatment.

Method: we performed a cross sectional observational study on 108 diabetic patients, who met the inclusion criteria. All the patients of both genders (female and male) with diabetes having diabetic retinopathy and disc findings suggestive of glaucoma were enrolled in the study to evaluate the prevalence of different types of glaucoma among diabetic retinopathy patients. Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) was assessed using Snellen’s chart and patient and illiterate patients was assessed using landont’s C chart. Anterior segment evaluation was done by slit lamp. IOP was determined by Non-Contact Tonometer & Goldmann applanation tonometer.

Angle of anterior chamber was assessed by performing gonioscopy with Zeiss four mirror gonio lens. Central corneal thickness was measured using ultrasonic pachymeter. Dilated fundus examination with slit lamp biomicroscopy (using 90D and 78D Zeiss lens).

Visual field examination was done using Humphrey’s automated static perimetry with SITA standard algorithms. Perimetry results with reliable indices were considered for our study. In patients not cooperating for perimetry or with repeated unrealizable results, Optical coherence tomography (OCT) was done for fundus glaucoma. All the cases data were recorded on a pre-designed proforma.

Conclusion: A cross sectional and observational study was required to access burden of glaucoma among patients of diabetic retinopathy, as both of these ocular disease represents the major ocular morbidity among population and leading cause of blindness worldwide and majorly affecting developing countries like India.

There are many comparative studies already done for correlation between eyes with Diabetic retinopathy and Glaucoma. A lot of theories have already been put forward describing common pathophysiology of both the diseases as well there were some theories who denied the association of glaucoma and diabetic retinopathy, describing both diseases as independent cause of blindness. In present study we are conclude that there is a correlation between diabetic retinopathy and glaucoma however there are many underline causes which may indirectly affect glaucoma progression which are need to be evaluate.

Early detection and treatment of glaucoma can prevent patient from blindness. The findings of the present study suggest that most of the diabetic patients undergo many physical and lab investigation however they missed out ocular check-up which is equally required. However further larger studies are required.