Challenges of glaucoma service delivery in Federal Medical Centre, Azare, Nigeria.

To find out the challenges of management of glaucoma, an assessment of glaucoma services at the Federal Medical Centre, Azare was carried out through oral interviews of ophthalmic staff, enquiring about available personnel and diagnostic equipment from relevant sectors of the Hospital and local authorities. A retrospective analysis of records of glaucoma patients (aged > 20 years) who presented at the centre between February 2002 and July 2007 was carried out. The ophthalmology unit has 6 ophthalmic nurses, 1 ophthalmologist and 1 optometrist. Instruments available were: A Schiotz tonometer, a slit lamp biomicroscope, a Volk +90 Diopter lens, a Goldman applanation tonometer, a l-mirror gonioscopy lens, a non contact applantation tonometer and a visual field analyzer. All the patients treated conservatively had guttae timolol 0.5% either solely (64 eyes, 50.8%) or in combination with other intraocular pressure lowering eye drops. Only one patient was treated with guttae latanoprost 0.005% (Xalatan). The only type of surgery carried out was Trabeculectomy in 22 eyes (14.0%). No intra or post operative antifibrotic agent was used. There is a dire need of human and infrastructural facilities for adequate management of glaucoma in the centre.