Proportion of ocular hypertension from a community-based screening program in South-Western Uganda

Abstract

Background: Glaucoma is the second leading cause of blindness globally. Africa has the highest burden of undetected cases of glaucoma and, the majority of patients present to the hospitals late with severe glaucoma partly due to the limited access to glaucoma screening equipment, and few trained eye care personnel. Ocular Hypertension (OHT), defined as an Intraocular Pressure (IOP) of >21 mmHg with normal optic nerve head findings and no other ocular disease is a risk factor for the development and progression of glaucoma. Uganda has limited data on the prevalence of OHT. Objective: We aimed to determine the proportion of OHT in South Western Uganda. Methods: This was a retrospective analysis of the IOP data of 5962 participants from a community-based outreach eye screening program. The IOP was measured using i-care100 rebound tonometer. The eyes were examined using a torch light and a direct ophthalmoscope. History of hypertension and diabetes treatment were obtained, and the blood pressure and random blood sugar measured. Data analysis involved a t-test, and logistic regression using STATA 7. Results: The mean age was 48.2 years. The majority, 56.2% were female. Systemic hypertension was present in 23.9% and diabetes in 2.3%. The mean IOP was 15.5 mmHg (SD ±4.9). The prevalence of OHT was 12.6% (n = 731). At bivariable analysis, female sex (OR 0.85, 95% CI 0.73–0.99, and p= 0.049), diabetes (OR 1.45, 95% CI 0.85–2.48, and p= 0.17) and systemic hypertension (OR 1.45, 95% CI 1.18–1.77, and p= 0.000) were associated with OHT, while systemic hypertension was the only factor associated with OHT at multivariable analysis (adjusted odds ratio 1.5, 95% confidence interval 1.23–1.92, and p-value = 0.000). Conclusion: We found a high prevalence of OHT in southwestern Uganda. OHT was associated with systemic hypertension.