Surgical treatment of open angle glaucoma is preferable to medical management in Africa.

Primary open angle glaucoma is the third leading cause of blindness in Africa, causing roughly 16% of all blindness and thereby involving approx. 800,000 people on the continent. The overall prevalence and age-group breakdown of the disease is similar to that in industrialized countries, involving almost exclusively people over 40, and rising steadily thereafter with age. Factors such as a generally asymptomatic disease, definitely symptomatic medical treatment, the high cost of drugs and their irregular availability, difficulties in obtaining adequate long term chronic follow-up, and poor patient understanding of the disease all combine to make medical therapy of this condition unacceptable in Africa. Modern surgical techniques are safe, effective, and comparatively cost effective in the treatment of glaucoma. Early surgery is therefore recommended whenever possible.