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70th AIOC Proceedings, Cochin 2012patients. It uses low coherence near infrared light (850 nm) from a superluminescent diode and subsequent back scattering of the retina. It generatesposterior segment measurement with an axial resolution of 8–10 microns.We hereby compare the cup disc ratio with an ophthalmoscope and OCT tofind the usefulness of OCT in detecting glaucoma and the reliability of theophthalmoscopic examination.284MATERIALS AND METHODSThis is a prospective study. It includes 200 eyes of 100 patients referred toglaucoma services during the period of December 2010 to March 2011. Thepatients were divided into two groups namely glaucoma suspects (Group A)and established glaucomas (Group B).Group A had 96 eyes of 48 patients. Out of them 28 were male and 20 werefemale. Two eyes of Group A, OCT was not possible due to poor co-operation.Effectively 94 eyes were taken for comparison.104 eyes of 52 patients of Group B. Out of them 29 were male and 23 werefemale. In Group B, OCT was not possible in 19 eyes (poor vision) and 5 eyes(poor media clarity) respectively. Effectively 80 eyes were taken for comparisonThe difference of cup disc ratio between direct ophthalmoscope and OCTof values less than 0.1 is considered comparable and values more than 0.1 isconsidered increased.In Group A, 58 eyes showed increased cup disc ratio in OCT as compared towhen examined with an ophthalmoscope. In rest of the 36 eyes, the cup discratio was comparable to that of OCT. 42 eyes of Group B showed increased cupdisc ratio when compared to ophthalmoscopic examination. Rest of the 38 eyeswas similar to values obtained by OCT.OCT overestimates the cup disc ratio in 61% of the glaucoma suspects and52% of established glaucoma respectively. Thus clinical examination is moreimportant. So OCT can be used only as an adjunct in diagnosing glaucoma.In glaucoma screening, for mass population fundus can be examined withdirect ophthalmoscope. All the primary health centres can be provided withan ophthalmoscope and medical officers can be trained to identify increasedcup disc ratio so that the cases can be referred to higher centres for completeglaucoma evaluation.• If you diagnose glaucoma early you can treat it early,• If you treat it early you can slow the rate of progression,• If you slow the rate of progression you can prevent blindness• Prof. Weinreb
Glaucoma Free PapersREFERENCES1. Shields textbook of glaucoma – sixth edition 2011.2. Becker Shaffer’s diagnosis and therapy of glaucoma – eighth edition 2009.3. Glaucoma – Concepts and fundamentals - Tarek, M.E.D George l. Spaeth.4. Greaney M J, Hoffman CD, Garway DF et al. Comparison of optic nerve imagingmethods to distinguish nirmal eyes from those with glaucoma. Invest Ophthal VisSci. 2002;43:140-5.5. Morgan J. E, Waldock A, Jeffery G et al. Retinal nerve fibre layer polarimetry:historical and clinical comparison. Br J Ophthalmol 1998;82:684-90.6. Watkins R, Panchal L, Uddin J, Gunvant P Vertical cup-to-disc ratio: agreementbetween direct ophthalmoscopic estimation, fundus biomicroscopic estimation,and scanning laser ophthalmoscopic measurement.Prevalence of Glaucoma in Patients Referred forCataract Surgery from Rural Screening CampsDr. Varada Gokhale, Dr. Sripriya Krishnamoorthy, Dr. Sandeep MarkThirumalai, Dr. Ronnie Jacob GeorgeCataract and glaucoma are frequently coexisting ocular conditions in theelderly population. Both can be a natural part of the aging process. Manypeople over 60 may have both of these serious sight threatening conditions.Glaucoma is responsible for significant ocular morbidity in India. Primaryglaucoma accounts for 2/3rds of the morbidity. 1 A significant portion of thosewho had undergone cataract surgery from rural cohort of Chennai glaucomastudy had glaucoma. 2 There is a growing acceptance that the prevalence andpredominant type of glaucoma show racial variability. Population-basedsurveys in the age group 40 years and older in different races have shownlarge variations.Since rural India is comparatively underserved in terms of both availabilityand quality of ophthalmic care it is possible that the reported rate of glaucomais an exaggeration. 3We report our data on prevalence of glaucoma in patients referred for cataractsurgery from rural screening camps.MATERIALS AND METHODSA retrospective review was conducted of all patients diagnosed with cataractand referred from rural cataract screening camp for cataract surgery toJaslok community ophthalmic centre, a unit of Medical Research Foundation,Chennai.285
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