{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:40:40Z","timestamp":1792453240460,"version":"4.5.0"},"reference-count":35,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,8,25]]},"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                  <jats:title>Purpose of the study<\/jats:title>\n                  <jats:p>Glaucoma, a chronic non-communicable disease, and leading cause of irreversible blindness worldwide is a public health problem in Nigeria, with a prevalence of 5.02% in people aged \u226540\u2005years. The purpose of this nationwide survey was to assess Nigerian ophthalmologists\u2019 practice patterns and their constraints in managing glaucoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study design<\/jats:title>\n                  <jats:p>Ophthalmologists were sent a semistructured questionnaire on how they manage glaucoma, their training in glaucoma care, where they practice, their access to equipment for diagnosis and treatment, whether they use protocols and the challenges they face in managing patients with glaucoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>153\/250 ophthalmologists in 80 centres completed questionnaires. Although 79% felt their training was excellent or good, 46% needed more training in glaucoma diagnosis and surgery. All had ophthalmoscopes, 93% had access to applanation tonometers, 81% to visual field analysers and 29% to laser machines (in 19 centres). 3 ophthalmologists had only ophthalmoscopes and schi\u00f8tz tonometers. For 85%, a glaucomatous optic disc was the most important feature that would prompt glaucoma work-up. Only 56% routinely performed gonioscopy and 61% used slit-lamp stereoscopic biomicroscopy for disc assessment. Trabeculectomy (with\/without antimetabolites) was the only glaucoma surgery performed with one mention of canaloplasty. Poor compliance with medical treatment (78%) and low acceptance of surgery (71%) were their greatest challenges.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study indicates that a systems-oriented approach is required to enhance ophthalmologist's capability for glaucoma care. Strategies to improve glaucoma management include strengthening poorly equipped centres including provision of lasers and training, and improving patients\u2019 awareness and education on glaucoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012230","type":"journal-article","created":{"date-parts":[[2016,10,11]],"date-time":"2016-10-11T21:38:53Z","timestamp":1476221933000},"page":"e012230","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Ophthalmologists' practice patterns and challenges in achieving optimal management for glaucoma in Nigeria: results from a nationwide survey"],"prefix":"10.1136","volume":"6","author":[{"given":"Fatima","family":"Kyari","sequence":"first","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene and Tropical Medicine, International Centre for Eye Health, London, UK"},{"name":"Department of Ophthalmology, College of Health Sciences, University of Abuja, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winifred","family":"Nolan","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene and Tropical Medicine, International Centre for Eye Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,10,11]]},"reference":[{"key":"2025101811573104000_6.10.e012230.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.05.013"},{"key":"2025101811573104000_6.10.e012230.2","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s12886-015-0160-6","article-title":"A population-based survey for the prevalence and types of glaucoma in Nigeria. The Nigeria National Blindness and Visual Impairment Survey","volume":"15","author":"Kyari","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"2025101811573104000_6.10.e012230.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1167\/tvst.4.2.1","article-title":"Why do people (still) go blind from glaucoma?","volume":"4","author":"Susanna","year":"2015","journal-title":"Transl Vis Sci Technol"},{"key":"2025101811573104000_6.10.e012230.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.86.2.131"},{"key":"2025101811573104000_6.10.e012230.5","first-page":"29","article-title":"A review of the choice of therapy in primary open angle glaucoma","volume":"8","author":"Omoti","year":"2005","journal-title":"Niger J Clin Pract"},{"key":"2025101811573104000_6.10.e012230.6","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1038\/sj.eye.6701972","article-title":"What is practical in glaucoma management?","volume":"19","author":"Rotchford","year":"2005","journal-title":"Eye"},{"key":"2025101811573104000_6.10.e012230.7","first-page":"355","article-title":"Challenges of glaucoma service delivery in Federal Medical Centre, Azare, Nigeria","volume":"37","author":"Olatunji","year":"2008","journal-title":"Afr J Med Med Sci"},{"key":"2025101811573104000_6.10.e012230.8","first-page":"1","article-title":"Challenges in glaucoma management in developing countries: is Vision2020 ready for glaucoma?","volume":"18","author":"Standefer","year":"2009","journal-title":"Niger J Ophthalmol"},{"key":"2025101811573104000_6.10.e012230.9","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/IJG.0b013e318189158c","article-title":"Glaucoma in Africa: size of the problem and possible solutions","volume":"18","author":"Cook","year":"2009","journal-title":"J Glaucoma"},{"key":"2025101811573104000_6.10.e012230.10","first-page":"70","article-title":"Clinical features of primary glaucoma in Ibadan","volume":"11","author":"Ashaye","year":"2003","journal-title":"Niger J Ophthalmol"},{"key":"2025101811573104000_6.10.e012230.11","doi-asserted-by":"publisher","DOI":"10.1258\/004947506776593323"},{"key":"2025101811573104000_6.10.e012230.12","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4103\/1596-3519.55700","article-title":"Pattern of presentation and outcome of surgical management of primary open angle glaucoma in Kano, Northern Nigeria","volume":"6","author":"Lawan","year":"2007","journal-title":"Ann Afr Med"},{"key":"2025101811573104000_6.10.e012230.13","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4314\/tmj.v24i1.46419","article-title":"The types and treatment of glaucoma among adults in North Eastern part of Nigeria","volume":"24","author":"Olatunji","year":"2009","journal-title":"Tanzan Med J"},{"key":"2025101811573104000_6.10.e012230.14","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s10792-014-9903-2","article-title":"Glaucoma in southwest Nigeria: clinical presentation, family history and perceptions","volume":"34","author":"Adekoya","year":"2014","journal-title":"Int Ophthalmol"},{"key":"2025101811573104000_6.10.e012230.15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s12886-015-0097-9","article-title":"Primary open angle glaucoma in northern Nigeria: stage at presentation and acceptance of treatment","volume":"15","author":"Abdull","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"2025101811573104000_6.10.e012230.16","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.2147\/OPTH.S37145","article-title":"Economic burden of glaucoma in Rivers State, Nigeria","volume":"6","author":"Adio","year":"2012","journal-title":"Clin Ophthalmol"},{"key":"2025101811573104000_6.10.e012230.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.09.003"},{"key":"2025101811573104000_6.10.e012230.18","unstructured":"Dictionary, Medical Dictionary for Health Professions and Nursing @ Farlex. 2012. http:\/\/www.medical-dictionary.thefreedictionary.com (Last accessed 17 Jul 2016)."},{"key":"2025101811573104000_6.10.e012230.19","unstructured":"Reference.MD. 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