Functional Visual Assessment, Pattern of Manifestation and Refractive Status of Angle Closure Glaucoma in Bangladesh

Objective: To explore functional visual assessment, pattern of presentations and refractive status of angle closure glaucoma.

Method: A hospital based prospective study was carried out at the glaucoma clinic of Chittagong Eye Infirmary and training complex for ophthalmic studies for the period of one year. 50 PACG patients were included in this study. Visual acuity, objective and subjective refraction, IOP, slit lamp biomicroscopy, visual field examination, contrast sensitive, color vision, gonioscopy, indirect ophthalmoscopy was done and types of glaucoma were recorded.

Result: The mean age was 52.6 and the standard deviation was 8.13. The most frequent range of unaided visual acuity in right eye in log mar chart in this study was 0.3-0.8 and the percentage was 49% and in the left eye was the 0.3-0.8 and the percentage was 52%. The frequent range of visual acuity after spectacle correction in right eye was (0.0 log unit) and the percentage was 50% and in the left eye was (0.0 log unit) and the percentage was 45%; which was strongly statistically significant. In our study significantly found 63% patients were hyperopic in PACG group which was more identical. Maximum patients came with moderate to severe increased of intra ocular pressure ranges from 30-70mmHg and more than 40% had enlarged C:D ratio 0.9:1. 40% patients were come with tubular field loss in right eye and 28% was in the left eye with advanced glaucomatous field defects. 75% patients had tritan defect in both eyes and 30% patients had bilateral primary angle closure glaucoma and 70% had unilateral angle closure glaucoma with other glaucoma subtypes.

Conclusion: Most of the PACG patient was associated with Hypermetropia. Most of them presented with advanced visual field defect, severe increased in IOP, advanced glaucomatous changes, poor contrast sensitivity and tritan color vision defect in both eyes. Identifying risk factors, early diagnosis, appropriate investigations and proper management in time could prevent the prognosis of the diseases.

Keywords: Primary angle closure glaucoma; Intra ocular pressure; Color vision; Cup disc ratio; Visual acuity; Contrast sensitivity; Hypermetropia