Increasing Glaucoma Detection in Roatán, Honduras: The Value of Education and Intraocular Pressure Screenings

Abstract

Glaucoma is an ocular neuropathy that damages the optic nerve, leading to vision loss and blindness. Insidious in its presentation and difficult to diagnose, glaucoma is asymptomatic until irreversible harm is caused. Accounting for 12.6% of preventable blindness in Honduras, glaucoma inflicts considerable clinical, economic, and personal burdens on thousands of lives (Rosa et al., 2022). Early detection and treatment halves the risk of disease progression by lowering the intraocular pressure so that permanent harm to the optic nerve is avoided (Leskea et al., 2004). However, in Roatán, where access to ophthalmic care is lacking and awareness of the disease is scarce, many cases of glaucoma go undiagnosed or are poorly managed, leading to higher rates of irreversible and avoidable blindness (Varma et al., 2011; Delgado et al., 2019). This paper seeks to understand if a two-pronged community-based strategy, which combined an educational campaign with an intraocular pressure screening, was an effective means to increase ophthalmic care seeking behavior in Roatán, Honduras. To do this, community members were given information about glaucoma and their pressure was taken with an iCare tonometer. Those with elevated pressures were recorded and contacted about follow-up. These data were then compared to the number and identity of patients who sought out ophthalmic care during a one-week medical brigade on the island to determine if the community-based approach was effective in increasing screening and detection of glaucoma. With a 7.56% follow-up rate, the analysis determined that the implemented strategy was ineffective. This study reveals a lack of timely follow-up in Roatán, demonstrating limitations in the utilized method of screening and referral. Additional interventions should be examined to determine more successful methods to increase detection of glaucoma in Roatán.