The “silent thief of sight”: glaucoma treatment and management

Glaucoma, the primary cause of irreversible blindness worldwide, presents a tremendous challenge. Find out how Light for the World’s pioneering glaucoma treatment programmes work to create sustainable solutions.

The term ‘glaucoma’ relates to a group of conditions, characterised by progressive optic nerve damage and loss of visual field. Unlike many other eye diseases, eyesight lost due to untreated glaucoma cannot be restored. But vision loss can be prevented by timely intervention. 

Most forms of glaucoma do not show symptoms in the early stages, before vision loss has occurred. 

For the best outcome, patients suffering from glaucoma must be identified early, receive appropriate counselling and be referred to ophthalmologists who are trained in glaucoma treatment and diagnosis. Family members of those with glaucoma are also encouraged to get examined.

There are many challenges to treating glaucoma across Sub-Saharan Africa. Including inadequate training of eye health professionals and lack of equipment and awareness. 

“There is no single simple screening test to detect glaucoma early at community level,” says Dr. Geoffrey Wabulembo, Expert on Eye Health and Neglected Tropical Diseases at Light for the World. 

“This is compounded by the low awareness level among non-ophthalmic health workers and the community at large.”

Building on our eye health work in Burkina Faso, Ethiopia and Mozambique, in 2019, Light for the World launched a game-changing pilot programme to build up and strengthen glaucoma services in dramatically underserved regions, funded by Else Kröner Fresenius Foundation. 

At the time, neither Burkina Faso nor Mozambique had an ophthalmologist who was certified in glaucoma sub-specialty training. 

But over four years, we collaborated closely with national Ministries of Health and training institutions – as well as International Agency for the Prevention of Blindness, West African College of Surgeons, International Council of Ophthalmology, International Centre of Eye Health and The College of Ophthalmology for Eastern, Central and Southern Africa – with the aim of creating long-lasting sustainable change, embedded into national healthcare. 

Light for the World published the first ever Toolkit for the Management of Glaucoma in Sub-Saharan Africa, used to train eye health providers in glaucoma detection and treatment, and to simplify the management of glaucoma. The first of its kind, it contains guidelines to support ophthalmologists’ decision-making for appropriate glaucoma treatment.  

Based on this toolkit, we have trained nine ophthalmologists to specialise in glaucoma, 22 ophthalmologists have received glaucoma surgery training, and 118 general ophthalmologists have received glaucoma care training.

“The toolkit includes practical steps for raising awareness among health workers and the community, as well as guidelines for establishment of a glaucoma service in the health system” says Dr. Wabulembo. “If implemented across different countries, the kit would provide important benchmarks in treatment protocols, equipment investments and human resource requirements.” 

Seven eye health departments were equipped with crucial infrastructure for glaucoma treatment and diagnosis. A permanent surgical simulation lab was set up at Addis Ababa University Hospital to host intensive glaucoma surgical trainings for 12 general ophthalmologists from all over Ethiopia and Mozambique. Three trainings completed in 2023, financed by Novartis XOVA. 

Finally, we targeted health authorities, as well as the general public, to raise awareness about the effects of glaucoma. We worked alongside each National Eye Health Programme, as well as national ophthalmological societies, to create accessible information on glaucoma.

Together with our partners, we have worked hard to lay the groundwork for equitable and sustainable quality glaucoma treatment and care. 

In the coming years we plan to enhance glaucoma management by strengthening expertise and improving access to eye health services in Burkina Faso, Ethiopia and Mozambique, with efforts expanded to Uganda. 

We hope to further promote and roll out the Glaucoma Toolkit and to build sustainable local expertise on glaucoma within East Africa, working closely with national, regional and international ophthalmological associations and eye health networks to create sustainable change. 

“Light For the World’s approach is successful because of the collaborative and consultative approach in all undertakings of improving glaucoma management,” says Dr. Wabulembo.

If you are interested in partnering with us to expand our glaucoma programme – including a glaucoma fellowship programme and World Glaucoma Week awareness raising and treatment campaigns – get in contact with Dr. Geoffrey Wabulembo.