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10]

Original Article

Awareness and knowledge of glaucoma among

hospital workers at the University of Benin
Teaching Hospital, Benin City
Vivian Bose Osaguona, Omolabake Tolulope Edema
Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

A B S T R A C T
Background: Glaucoma is a disease of public health importance. We assessed the level of awareness and knowledge of glaucoma
among workers at the University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. Materials and Methods: This is
cross‑sectional study of hospital workers at the University of Benin Teaching Hospital, Benin City. Data on demographics, awareness
and knowledge of glaucoma was gathered through structured self‑administered questionnaires to a random sample of workers.
Statistical analyses were performed with the Statistical Package for Social Sciences 16 (SPSS Inc. 2007. SPSS for Windows,
Version 16.0. Chicago) software. Chi‑square test was used to assess for any statistically significant difference in the social demographic
factors such as age, gender, staff category, education, and duration of employment in the hospital and awareness of glaucoma. The
level of knowledge among the staff categories was also compared using the Chi‑square test. Statistical significance was taken as
P < 0.05. Results: There were a total of 226 respondents. 93 (41.2%) were in the age group of 21-30 years. 111 (49.1%) were males.
168 (74.3%) were aware of glaucoma. Awareness of glaucoma was higher among the paramedical staff and among workers with a
higher education (P < 0.001). The knowledge of glaucoma was good among 31% of those who were aware of glaucoma, fair in 31.5%
and poor in 37.8%. Conclusions: There is a need to educate hospital workers on glaucoma in order to raise awareness and increase
their level of knowledge such that blindness prevention from glaucoma may be possible from early diagnosis and prompt treatment
in these workers, their relatives, and contacts.

Keywords: Awareness, glaucoma, hospital workers, knowledge, Nigeria

INTRODUCTION In Nigeria, neighbors seek the hospital workers’ opinion

Glaucoma is a cause of visual impairment.[1‑5] Globally, it
is the second leading cause of blindness after cataract;[1]
and the leading cause of irreversible blindness.[2]
Primary open‑angle glaucoma, which is the most common
form of glaucoma in West‑Africa,[6‑8] is asymptomatic in its
early stages and more serious in blacks.[9] Lack of awareness
is a major risk factor for late presentation of glaucoma.[10]
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DOI:
10.4103/1118-8561.146816
on health‑related issues. The aim of this study is to
assess the level of awareness and knowledge of glaucoma
among workers in a tertiary hospital in Nigeria.
MATERIALS AND METHODS
This is a cross‑sectional study of hospital workers at the
University of Benin Teaching Hospital, Edo State, Nigeria,
a tertiary institution, located in an urban area of Nigeria
that provides specialist medical services including
ophthalmic services. Ethical approval was given by the
Ethics and Research Committee of the Hospital.
Data on demographics, awareness and knowledge
of glaucoma was gathered through structured
self‑administered questionnaires given to a randomly
sampled number of workers who were on seat and

Corresponding Author: Dr. Vivian Bose Osaguona, Department of Ophthalmology, University of Benin Teaching Hospital,
P.M.B. 1111, Benin City, Edo State, Nigeria. E‑mail: vivian_osaguona@yahoo.co.uk

132 Sahel Medical Journal / October-December 2014 / Vol 17 | Issue 4

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Osaguona and Edema: Awareness and knowledge of glaucoma

consented to the study in the major departments in the 168 (74.3%) of the respondents were aware of
hospital, which included Accounts, Personnel, Laundry, glaucoma. Awareness of glaucoma was higher among
Security, Pharmacy, Radiology, and Laboratory services. the paramedical staff and among the respondents
The respondents were required to fill the questionnaires with higher education (P < 0.001) [Table 2]. The most
as they were being given. Physicians and nurses were common source of information on glaucoma was from
excluded from the study. a doctor or nurse [Figure 1]. 4 (2.4%) of those who were
aware of glaucoma had previously been diagnosed
The questionnaires had a section for demographics.
Awareness of glaucoma was assessed with the Table 1: Sociodemographic characteristics of respondents
close‑ended question: Have you heard of glaucoma? Sociodemographic characteristics (n=226) n (%)
The source of information on glaucoma was obtained Age group (years)
through close‑ended questions with a list of possible 21-30 93 (41.2)
responses. Only those who were aware of glaucoma 31-40 58 (25.5)
41-50 45 (19.9)
were required to complete the next section on knowledge 51-60 30 (13.3)
of glaucoma. Knowledge assessed included etiology, Gender
risk factors, symptoms, treatment, and prevention of Male 111 (49.1)
Female 115 (50.9)
glaucoma. Only fully completed questionnaires were Educational level
included in the analysis. None 9 (4.0)
Primary level 22 (9.7)
Secondary level 54 (23.9)
The hospital workers were classified into three groups:
Tertiary level 141 (62.4)
Paramedical staff group (pharmacists, radiographers, Staff category
and laboratory scientists), nonmedical administrative Paramedical 76 (33.6)
Administrative 125 (55.3)
staff group and domestic/security staff group.
Domestic/security 25 (11.1)
Duration of employment (years)
Respondents were scored +1 for every correct ‘yes’/’no’ 0-5 128 (56.6)
response and −1 for every incorrect answer in the section 6-10 28 (12.4)
11-15 31 (13.7)
on knowledge. The total percentage score on knowledge 16-20 16 (7.1)
for each respondent was determined and a score of 70% >20 23 (10.2)
and above was regarded as good, 50-69% fair and less
than 50% poor. Statistical analyses were performed with Table 2: Awareness of glaucoma by sociodemographic
the Statistical Package for Social Sciences 16 (SPSS Inc. characteristics of respondents
2007. SPSS for Windows, Version 16.0. Chicago) software. Characteristics Awareness (n (%)) P value
Chi‑square test was used to assess for any statistically Yes No
significant difference in the social demographic factors Age group (years)
such as age, gender, staff category, and education, duration 21-30 75 (80.6) 18 (19.4) 0.067
31-40 44 (75.9) 14 (24.1)
of employment in the hospital, and awareness of glaucoma.
41-50 32 (71.1) 13 (28.9)
The level of knowledge among the staff categories was 51-60 17 (56.7) 13 (43.3)
compared using the Chi‑square test. A P < 0.05 was taken Gender
Male 82 (73.9) 29 (26.1) 0.876
to be statistically significant.
Female 86 (74.8) 29 (25.2)
Duration of employment (years)
RESULTS 0-5 100 (78.1) 28 (21.9) 0.592
6-10 20 (71.4) 8 (28.6)
>10-15 21 (67.7) 10 (32.3)
A total of 302 questionnaires were distributed to the >15-20 12 (75) 4 (25)
hospital workers, out of which 226 questionnaires were >20 15 (65.2) 8 (34.8)
completely filled, giving a response rate of 74.8%. Staff category
Paramedical 74 (97.4) 2 (2.6) 0.001
Admin and personnel 82 (65.6) 43 (34.4)
111 (49.1%) respondents were males while 115 (50.9%) Domestic security 12 (48) 13 (52)
were females, with a male to female ratio of Educational status
1:1.04. 93 (41.2%) were in the age group of 21-30 years. None 2 (22.2) 7 (77.8) 0.001
Primary school 6 (27.3) 16 (72.7)
Majority of the respondents 141 (62.4%) had tertiary Secondary school 37 (68.5) 17 (31.5)
education. Table 1 shows the socio demographic Higher institution 123 (87.2) 18 (12.3)
characteristics of the respondents. Total 168 (74.3) 58 (25.7)

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Osaguona and Edema: Awareness and knowledge of glaucoma
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Figure 1: Sources of information on glaucoma
with glaucoma but only 2 (50%) of them were on
treatment. 108 respondents (64.3%) had never had
an eye examination. Some responses to the definition
of glaucoma included: “An eye disease,” ”increased
intraocular pressure,” “intraocular pressure higher than
normal resulting in gradual loss of vision,” “increased
intraocular pressure, which leads to hypertension, if not
treated in time can damage the optic nerves.”
The knowledge of glaucoma was good among 31%, fair
in 31.5% and poor in 37.8% of those who were aware of
glaucoma. The knowledge of glaucoma was best among
the paramedical staff and worst in the domestic and
security staff (P < 0.001).
Only 18.5% of the respondents who were aware knew
glaucoma could be asymptomatic. 95 workers (56.5%)
responded that glaucoma was curable.
DISCUSSION
Awareness of glaucoma in developing countries has
been reported to be poor both in community – based
studies and among patients attending hospital or eye
camps.[10,11‑17] On the contrary, however, studies in the
United Kingdom[18,19] and the United States[20] have
reported the awareness of glaucoma to be good.
To the best of our knowledge, few studies have been done
on the awareness and knowledge of glaucoma among
hospital workers.[21‑23] Adegbehingbe and Bisiriyu,[21]
in a study among hospital workers in Ile‑Ife, Nigeria,
reported 95.1% of the workers to be aware of glaucoma;
however, majority (92.7%) of their study population
were medical doctors and nurses. In another study in
Owo, Nigeria, Komolafe et al.[22] reported that 100% and
29.2% respectively of the respondents from the clinical
134 Sahel Medical Journal / October-December 2014 / Vol 17 | Issue 4
directorate and the administrative directorate had heard
of glaucoma. In India, Ichhpujani et al.[23] conducted a
study among physicians and nurses, all of whom were
aware of glaucoma. The high level of awareness among
the clinical staff in these studies is not surprising as they
are expected to have had lectures on glaucoma in the
course of their training. Unlike these studies, physicians,
and nurses were excluded from our work in which 74.3%
0DVVPHGLD of the respondents were aware of glaucoma. Awareness
 of glaucoma was higher among the paramedical staff
and among workers with a higher education, which
were statistically significant. Most of the paramedical
staff had heard of glaucoma in the course of their school
training. Those with higher education are more likely to
have associates who are doctors or nurses, and are more
likely to read or listen to articles on health‑related issues.
Our study did not show any statistically significant
difference among the age groups, gender and awareness
of glaucoma. In other studies, varying differences among
age groups, gender and awareness of glaucoma have
been reported, but awareness of glaucoma was higher
in those with a higher education in all of them.[12,14‑16,19,20]
We also found that the period of employment within the
hospital did not differ significantly in the awareness of
glaucoma, which may imply that a person may work
within a hospital environment and still be ignorant about
diseases of public health significance.
Glaucoma is a disease of public health importance
because it has a high prevalence, can be asymptomatic
until the advanced stages, causes irreparable visual loss
and is incurable. It is notable that only a minority (18.5%)
of our respondents knew that glaucoma could be
asymptomatic and more than half (56.5%) responded that
it was curable. Similarly, in other studies that included
physicians and nurses, only 21.7% of the respondents
knew that glaucoma could be asymptomatic in the
early stages,[22] while 39.5% of respondents reported
that damage from glaucoma could be reversed.[23] On
the whole, the knowledge of glaucoma was good among
the hospital workers in this study, knowledge being
best among the paramedical staff and worst among the
domestic and security staff, who also had the lowest
educational status. In the population‑based study in
Chennai, South India, the knowledge of glaucoma was
worst in those with lower education.[14] Those with
lower education are less likely to be well‑informed.
Despite the high level of awareness among our
respondents, 63.3% of those who were aware had
never had an eye examination and only 50% of those
previously diagnosed with glaucoma were on treatment.
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Osaguona and Edema: Awareness and knowledge of glaucoma

This shows a poor health‑seeking behavior among the
hospital workers.
From our study, we found that being a hospital worker did
not translate into being aware of or being knowledgeable
about glaucoma. In a society where people tend to seek
the opinion of those who work in the hospital even
when they are nonmedical personnel on health‑related
matters (which makes the hospital worker a source of
health information in his community), it is paramount
for hospital workers to be aware of and to have good
knowledge of glaucoma, which is the “sneak thief of
sight.” This will enable them have the right knowledge
about glaucoma, have positive health‑seeking behaviors
toward it and also be able to advise those who seek
their opinions appropriately. Thus, we advocate that
hospital management teams should organize health
education programs on glaucoma geared at enlightening
all workers about the disease and influencing positive
health‑seeking behaviors. This will impact positively
on blindness prevention from glaucoma as eye health
education can save needless blindness and suffering and
can also reduce the economic burden of a disease.[24]
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Cite this article as: Osaguona VB, Edema OT. Awareness and knowledge of
glaucoma among hospital workers at the University of Benin Teaching Hospital,
Benin City. Sahel Med J 2014;17:132-5.
Source of Support: Nil. Conflict of Interest: None declared.

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