Prevalence and factors associated with raised Intraocular Pressure among Hypertensive Patients attending the Hypertension Clinic in Mulago National Referral Hospital

Abstract

ABSTRACT Introduction: Glaucoma is the leading cause of irreversible blindness in the world, accounting for 8% of all blind people (WHO, 2012) and systemic hypertension is thought to increase the risk of development of glaucoma. Raised intraocular pressure is the only modifiable risk factor of glaucoma development and progression that can be treated medically and / or surgically and yet little is known in our setting about the magnitude of raised intraocular pressure among the vulnerable group of patients with systemic hypertension. Objective: To determine the prevalence of raised Intraocular pressure and associated factors among hypertensive patients attending the hypertension clinic at Mulago National Referral Hospital. Methods: This was a hospital-based cross-sectional study, conducted over a period of four months in Mulago National Referral Hospital, in the hypertension clinic and 405 hypertensive patients were sampled. Participants were sampled consecutively and underwent both a general medical and ocular examination. A questionnaire was used to collect data on socio-demographic characteristics, ocular and medical factors. Results: Of the 405 hypertensive study participants, mean age was 57.1 years (range 25 to 90 years, SD = 12.4 years). The overall prevalence of raised intraocular pressure was 11.6% (95% CI 8.8 – 15.1). The mean IOP among all participants was 15.2mmHg (SD=4.3) with a range of 3-34 mmHg. The factors with a statistically significant association with raised intraocular pressure after multivariate analysis were a positive family history of Glaucoma (OR 57, CI 10.33 – 315.34, P0.000) and Eye trauma (OR 7.84, CI 1.02 – 60.02 P0.047). Conclusion and Recommendations: The prevalence of raised intraocular pressure among hypertensive patients attending the hypertension clinic in Mulago National Referral hospital was found to be high. Routine screening and monitoring of IOP among hypertensive patients is advised to promote early detection and intervention to prevent Glaucoma-associated blindness.