Non-Glaucomatous Causes of Decreased Vision in Glaucoma
Purpose: To determine the non-glaucomatous causes of decreased visual acuity in glaucoma patients presenting in the eye OPD of a tertiary care hospital.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Abbasi Shaheed Hospital from July 2019 to September 2020.
Methods: Patients above 18 years of age, visual acuity of less than 6/6 and diagnosed case of glaucoma were included in this study. Patients with congenital glaucoma and patients not willing to participate in the study were excluded. Detailed history was taken and ocular examination of the patient was done. Causes of decreased visual acuity were determined. Data was collected and analyzed on SPSS version 20.
Results: There were 369 glaucoma patients with a mean age of 58.2 ± 11.54 SD years. Males were 224 (60.4%), with mean duration of glaucoma as 5.4 ± 5.2 years. Primary open-angle glaucoma was seen in 209 (56.6%) and primary angle-closure glaucoma was in 96 (26%) of patients. Treatable causes were 119 (32.2%) and non-glaucomatous causes of decrease vision were 221 (59.9%). Glaucomatous optic atrophy was seen in 182 (49.3%) patients followed by cataract in 96 (26%). Patients with corneal pathologies were 38 (10.2%) and ARMD were 26 (7%).
Conclusion: The commonest cause of decreased visual acuity in glaucoma patients is irreversible glaucomatous optic atrophy. Age-related macular degeneration, corneal pathologies, and amblyopia also contribute to irreversibly decreased visual acuity in glaucoma patients. Reversible causes include cataract, refractive errors, cystoid macular edema and diabetic macular edema.
Key Words: Cataract, Glaucoma, Glaucomatous Optic Atrophy, Vision.