Rakshya Panta Sitoula
Biratnagar Eye Hospital
Nepal
Title: Congenital glaucoma: Challenges in management in developing countries
Biography
Biography: Rakshya Panta Sitoula
Abstract
Primary congenital glaucoma is a specific term referring to eyes that have isolated mal-development of trabecular meshwork without other ocular anomalies or diseases that can raise IOP. It has an incidence of approximately 1 in 10,000 live births. Though a rare entity it poses a major challenge in management in developing countries. We prospectively looked at case series of 11 patients with primary congenital glaucoma that presented to Biratnagar Eye Hospital (Nepal) from November 2014 to October 2015. All patients underwent examination under anesthesia. On the basis of corneal diameter, IOP, CDR who met the criteria, were subjected to combined trabeculotomy with trabeculectomy (19 eyes of 11 patients). We operated these patients in as low cost as NPR 1200 which is equivalent to approximately 10 Euro. There were 11 patients (6 males and 5 females); mean age of first consultation was 10.73.8 months. Eight patients had bilateral involvement and 3 had unilateral involvement. Mean vertical corneal diameter was 12.8 1mm and horizontal corneal diameter 13.51 mm. The mean IOP was 45  8 mm of Hg. The surgical intervention led to clearance of corneal haziness, symptomatically relieved children and enhanced functional results; however the most important challenges in our scenario were late presentation with advanced disease. The reason for so being the financial constrains, geographic barrier and lack of awareness about the treatment.