At this moment it has become very clear, that laser treatment of glaucoma in Africa as a primary treatment (as opposed to eye drops) is an emerging standard of care in Tropics. SLT as substitution for eyedrops, Cyclophotocoagulation as a substitution for primary trabeculectomy… We are arriving at the new era.
Assessment of eye drop instillation techniques among patients with primary open angle glaucoma in a Nigerian tertiary hospital
Olapeju A Sam-Oyerinde et al. Int Ophthalmol. 2021.
Approximately everyone does not wash their hands before the instillation. And ~30-40% touch the eye during inatillations. This was tested in Nigeria on glaucoma patients.
First ever African Glaucoma Guidelines! A Toolkit for Glaucoma Management in Sub-Saharan Africa (Light for the World, Sightsavers, IAPB, ICO, SAFO, COECSA, WACS), 2021
Eye basically exploded 2 days ago. And the patient came with painful blind eye and almost absent cornea and contents out. Patient lost his old file number, but we managed to get the history of timolol prescription last year. Which he didn’t use of course – the drops costed $3 and he only had glaucoma. It’s not painful to have glaucoma, so some prefer to live and leave it. Until the eye explodes sometimes.
So he presented with contents out, absent cornea and moderate pain. The management here is controversial regarding which type of amputation to perform (and I am open for private discussions). But in absence of strong tumor suspicion both evisceration and enucleation are valid options.