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Abstract #11670 Published in IGR 7-1
Strategy for decentralised prevention of angle closure glaucoma in Greenland
Alsbirk PHInternational journal of circumpolar health 2004; 63: 315-319
In 1962 a blindness survey showed glaucomas to be responsible for 64% of all blindness in Greenland. In 1968 primary angle closure glaucoma was found to be the major glaucoma problem. Population studies using gonioscopy, optical anterior chamber depth, corneal thickness, diameter- and curvature measurements as well as ultrasound biometry were gradually performed. Prevalence was estimated at 5.1% in women and 1.6% in men aged 40+. Main findings were eye traits associated with increased risk of angle closure glaucoma: shallow anterior chamber depth and small corneal diameters. A high heritability (70%) was found. Surgical iridectomies and later YAG-laser iridotomies were introduced as routine procedures by travelling consultants and at the referral centre Rigshospitalet in Copenhagen. Eventually, in 1993-96 a surgical eye clinic was established in the capital Nuuk, also introducing phakoemulsification cataract surgery. Blindness due to glaucomas had fallen to about 9% of the registrations in Greenland per 1999. In 1999 an outreach model had to be established again, including consultants covering the 16 districts in 45 weeks and surgical teams of 2 surgeons 3 x 3 weeks per year. In 2002 the coverage was reduced to 31 weeks and only two surgical tours. The possible consequences for glaucoma blindness will be discussed.
Dr. P.H. Alsbirk, Greenland Eye Service, HovedOrtoCentret, Eye Clinic, Rigshospitalet, Copenhagen, Denmark. p.h.alsbirk@dadlnet.dk
Classification:
1.6 Prevention and screening (Part of: 1 General aspects)
9.3 Primary angle closure glaucomas (Part of: 9 Clinical forms of glaucomas)
