INTRODUCTION

Background of Study

In developing countries lack of information and ignorance contribute to the

deteriorating condition of client eye. In some cases the problem of waiting for a

long period of time in the hospital wasting a whole day there makes most

clients visit chemist and quacks in most cases wrong medications were given

that lead to serious complication.

The meeting of the basic needs for living such as food production to feed the

family overrides all other concerns like going to the hospital. Once vision

deteriorates to a point where daily functions can no longer be performed the

client becomes dependent on the family members completely for his sustenance.

Most clients are living below poverty level and find it difficult to purchase eye

drops which are normally very expensive (Ume 1987)

Glaucoma is one of the leading causes of irreversible blindness in the world and

is the leading cause of blindness among adults in the United States. It is

estimated that at least 3 million Americans have glaucoma and risk (Schacht

Quigley Sherri et al 2004)

Suzanne and Brenda (2008) stated that glaucoma is more prevalent among

people older than 40yrs of age and the incidence increases with age. It is also

more prevalent among men than women and in African American and Asian

populations. Loss of vision is believed in some part of the country to be due to

evil spirit. There is traditional superstitious belief that Evil spirit can cause

blindness (Abdullah 1993).

Man is supposed to be in a state of health a condition that is generally accepted

to be a complete physical mental and social well being which enhances the

individual ability to function in a normal manner. Health is a state of complete

positive dynamism which gives rise to physical mental social and full

satisfaction with absence of disease on infirmity (WHO 1976).

Glaucoma is an increase intra ocular pressure sufficient to cause damage to the

structures of the eye most especially the optic nerve which transmits impulses of

message of pictures to the brain for interpretation. It is characterized by loss of

peripheral vision severe headache and silent destructive cause of Blindness.

(Ade 1999)

Suzanne and Brenda (2006) Elicited that Glaucoma is a group of ocular

conditions characterized by optic nerve damage. The optic nerve damage is

related to the intra ocular pressure by congestion of aqueous humor in the eye.

Glaucoma is becoming increasingly a cause of Blindness. It occurs at any age

but is more common to people over the age of forty years. It is responsible for

about 10% to 15% of causes of Blindness worldwide (Federal Ministry of

Health 2000)

Currently there is no cure for glaucoma worldwide but continuing research has

shown a significant result in successfully controlling the disease through the use

of chemotherapy such as anti-glaucomatous drugs used to lower intraocular

pressure like diamox and drops timoptol. Similarly surgical intervention is done

to restore the little vision left but not to maintain the normal vision.

Glaucoma is not a single disease but a group of disorders resulting in optic

neuropathy and vision loss. These may be broadly classified as open angle or

angle closure glaucoma based on the anatomy of the eyes anterior chamber and

are further classified as primary or secondary (Mustapha 1999)

Early diagnosis is difficult because there is no single test or examination which

is sufficient sensitive or specific to be used alone to screen the population for

the disease. The inhabitants of Sokoto State are mostly civil servants traders

and farmers who are low income earners. The problem of ignorance poverty

and visit to the traditional medicine practitioners and chemist make most clients

to come to the hospital late when they come in such bad condition the client

looks frustrated and forlorn they came with high hope that once they reach

hospital their problems would be solved. Clients spend a lot of money with all

anticipation that all would be well. For some their vision are preserved but for

others damage has affected the optic nerve so vision lost cannot be resumed and

such client would be dependent on his family and relatives all the rest of his life.

This adds strains to his family caring for adult blind. Assessment is the ongoing

process of gathering analyzing and reflecting on evidence to make an informed

and consistent. Assessment is also the evaluation or estimation of the nature

quality or ability of someone or something (The free dictionary)

In Nursing assessment is identification by a nurse of the needs preferences and

abilities of a patient. Assessment includes; an interview and observation of a

patient by a nurse and consider the signs and symptoms of a condition the

patient verbal and non-verbal communication the patient’s medical and social

history and any other information available. (Mosby 2009).

Management is the process of dealing with or controlling things or people the

responsibility for and control of a company or similar organization (Wikipedia

the free encyclopedia). Nursing management is a branch of the nursing field

focused on managing nurses and patient care standards (Wikipedia the free

encyclopedia)

The researcher is therefore motivated to assess the management strategies of

glaucoma in specialist hospital Sokoto.

Statement of the Problem

The researcher was challenged by the increasing number of clients with

glaucoma. There are various method used in glaucoma management used both

locally and globally to reduce the high incidence of blindness worldwide. But in

spite of this there is seemingly an increasing number of glaucoma patients seen

in the ophthalmology department in specialist hospital Sokoto. It is envisaged

that this study would provide an overview of the causes of such increase. This

prompted the researcher to find out the pattern of management of glaucoma

patients with view of making appropriate recommendations for improved care.

Purpose of the Study

The purpose of this study is to identify

1. Material resources available for managing glaucoma in Specialist

Hospital Sokoto

2. Human resources available for Glaucoma Management in Specialist

Hospital Sokoto

3. The laboratory investigation measures available for Glaucoma

Management in Specialist Hospital

4. Strategies employed in the Management of Glaucoma in Specialist

Hospital Sokoto.

Significance of Study

The findings of this study when adopted and implemented by the

ophthalmologist would be useful to the patient care. There by bringing about

reduction in the number of patient losing their sight. To the community when

the number of people with loss of sight are reduced by the improve management

strategies for glaucoma the community will have less boredom of caring for the

adult blind. The hospital management and the professionals will use the

generated data to come up with strategies for improving glaucoma management

by the ophthalmologist. To the government the recommendation of the study

will help the government in effecting ‘policies and programmes for a more

improved glaucoma management. To the field of knowledge: the work will be

used as a guide or referencing for anybody who wants to further the study in

similar area.

Research Questions

The study will be guided by the following questions

1. What are the material resources available for the glaucoma management

in Specialist Hospital Sokoto?

2. To what extent are the Human resources available for glaucoma

management in Specialist Hospital Sokoto?

3. What is the current laboratory investigation used for glaucoma Diagnosis

in Specialist Hospital Sokoto?

4. What are the strategies used in the Management of Glaucoma in

Specialist hospital Sokoto?

Scope of the Study

The study is based on the Assessment of glaucoma management in specialist

hospital Sokoto. The study is only limited to the strategies of glaucoma

management material resources human resources and the current laboratory

investigative measures used to improve skills in the Glaucoma Management in

Specialist Hospital Sokoto.