Original Article

Knowledge and awareness of glaucoma in a population of

Abha, Southern Saudi Arabia
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Abdulrahman Alamri, Khulud Ali Bakri, Shahd Mohammad Alqarni,

Maram Nawar Alosaimi, Ebtihaj Yahya Alshehri, Mariam Salem Alshahrani
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Department of Ophthalmology, College of Medicine, King Khalid University, Abha, Saudi Arabia

A bstract
Background: Glaucoma is a disease that results in a painless elevation of intro ulster pressure (IOP), which can lead to progressive
optic nerve damage and visual field loss. According to the World Health Organization (WHO), glaucoma is the second leading cause
of irreversible blindness worldwide. It is certain that understanding the disease and knowing the people most susceptible, such
as those with chronic diseases such as diabetes and hypertension may help treat the condition and check it regularly to avoid
irreversible blindness. Materials and Methods: This study was done to measure the extent of people’s awareness and knowledge
about glaucoma. The study was cross sectional and used a questionnaire to find about the awareness of glaucoma among the
residents of Abha. The sample size was 1563. It was conducted within 2 months of taking ethical approval and informed consent.
Data was analyzed by statistical package for the social sciences (SPSS) program, version 22. Results: The study results showed
that around 77.1% of the respondents had heard about glaucoma. Of the 1563 participants, the majority were women and they
constituted 81.0%. Nearly 88.3% replied that glaucoma may lead to blindness and 86.9% agreed that early screening helps avoid
the complications of glaucoma. Although just 5.4% did glaucoma screening, 43.0% concurred that this blindness can be treated.
Conclusion: Current research evaluated the awareness and knowledge of glaucoma among the residents of Aseer. Good awareness
level regarding glaucoma was found among 725 respondents (46.4%) and 53.6% had poor awareness.

Keywords: Abha, awareness, glaucoma, knowledge, southern Saudi Arabia

Introduction The well‑established risk factors for glaucoma include family

Glaucoma is the leading reason of blindness. Because of lack
of understanding and information about glaucoma.[1] Glaucoma
causes gradual progressive asymptomatic vision loss, which
is often not observed until substantial field loss has already
occurred. This is due to chronic optic neuropathy, characterized
by optical disk cupping and loss of sight.[2]
Address for correspondence: Dr. Abdulrahman Alamri,
Department of Ophthalmology, College of Medicine,
King Khalid University, Abha ‑ 641,
Saudi Arabia.
E‑mail: amaamri@gmail.com
Received: 28‑11‑2020 Revised: 16‑02‑2021
Accepted: 18-02-2021 Published: 31-10-2022
Access this article online
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history, increasing age, and raised intraocular pressure.[3,4] There are
various forms of glaucoma, which helps clarify why one glaucoma
patient may have no symptoms while another experiences sudden
pain and inflammation, for example. There is no related ocular
disorder (primary glaucoma) in most cases.[4] The study of global
prevalence of glaucoma and projections of glaucoma burden
through 2040 concluded that the global prevalence of glaucoma
for population aged 40–80 years is 3.54%. The prevalence of
primary open angle glaucoma (POAG) is highest in Africa, while
that of primary angle closure glaucoma (PACG) is highest in Asia.
In the year 2013, the number of individuals (aged 40–80 years)
with glaucoma globally was projected to be 64.3 million,
increasing to 76.0 million in 2020 and 111.8 million in 2040. A
study conducted in a primary health center (PHC) in northern
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How to cite this article: Alamri A, Bakri KA, Alqarni SM, Alosaimi MN,
DOI: Alshehri EY, Alshahrani MS. Knowledge and awareness of glaucoma in
10.4103/jfmpc.jfmpc_2346_20 a population of Abha, Southern Saudi Arabia. J Family Med Prim Care
2022;11:6165-9.

© 2022 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer ‑ Medknow 6165
 Alamri, et al.: Glaucoma awareness among the people of southern Saudi Arabia

Saudi Arabia found the glaucoma prevalence to be 5.8%. While Table 1: Personal data, source of information, and
the severity and determinants of glaucoma based in the hospital practice of the sampled population
are recognized in some parts of Saudi Arabia, the prevalence of Personal data and practice No. %
glaucoma based in the population remains unknown.[5,6] Gender
Male 297 19.0
The main objective of this study is to assess the level of awareness Female 1266 81.0
and knowledge of glaucoma in the general population of Abha city. Age in years
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18‑28 985 63.0

Materials and Methods 29‑39 334 21.4
40‑50 193 12.3
In this cross‑sectional study, data was obtained using a >50 51 3.3
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questionnaire constructed for the purpose; the questionnaire was
composed of demographic questions and items related to
awareness of glaucoma. Forward and backward translation of the
questionnaire was done. Method of data collection was through
online questionnaire, which was adapted from a previous study
It was initially prepared in English by the coauthors. It was
translated to Arabic (Aseer region’s local language). Statistical
package for the social sciences (SPSS) ver. 20 software was used
for data analysis. Data was obtained by trained data collectors
after briefing the questionnaire to the respondents.
The means and standard deviation (SD) are used to present
continuous variables, while frequencies and percentages are
used to present the data. Chi‑square test was used to assess the
differences between groups. P value less than 0.05 was considered
as a significant value. The research was approved by the ethical
committee of the college. Duration of the study was from
January 2020 to April 2020.
Data collection took place in Abha city of Aseer region in Saudi
Arabia. The study was a cross‑sectional one conducted from April
2 to May 28, 2020 to determine the awareness of 1563 females
and males aged from 18 years up to more than 50 years about
glaucoma. The number of participants was estimated to be
about 1563, with 1266 (81%) females and 297 (19%) males. The
inclusion criteria were any adult above 18 years old and both male
and female residents of Abha. The exclusion criterion was people
under 18 years of age. Study was approved by the research ethical
committee of the college of medicine, King Khalid University.
Informed consent was obtained from all respondents.
Results
A total of 1563 respondents were included with age ranging from
18 to 65 years and a Mean (S.D) age of 25.2 ± 6.6 years. Exactly
1266 (81%) participants were females. Regarding the participants’
source of information about glaucoma, 772 reported it as internet
and social media (94.4%), followed by friends (32.6%; 509) and
physician (18%; 282). Immediate consultation in case of having
ophthalmic disorder was reported by 695 participants (44.5%),
while 222 (14.2%) reported they may wait for 2 days. Screening
for glaucoma was reported by 84 participants (5.4%) [Table 1].
Table 2 shows the awareness of the sample population regarding
glaucoma. Results showed that 1511 (96.7%) participants believed
Source of information for glaucoma
Doctor 282 18.0
Friends 509 32.6
Internet and social media 772 49.4
Duration till consulting physician in case of
having eye problems
Immediately 695 44.5
A day or two 646 41.3
After 2 days 222 14.2
Did you do screening for glaucoma before?
Yes 84 5.4
No 1479 94.6
that glaucoma should be treated early. Also, 1380 (88.3%)
participants thought glaucoma may lead to blindness and
86.9% agreed that early screening helps avoid complications of
glaucoma. People high ae is one the risk factor for glaucoma by
79.5% of the participants, while chronic diseases like diabetes
mellitus and hypertension are a risk factor of glaucoma was
reported by 72.6% of the participants and surgeries or previous
eye injury are risk factor of glaucoma (45.9%). Only 577
participants (36.9%) thought the only treatment of glaucoma is
surgical. Also, 89.5% of the participants felt that it is important to
tell your doctor that you have glaucoma to avoid medication that
can exacerbate the condition. Blurry lens as a cause of glaucoma
was selected by 35% of the respondents, followed by damage of
the optic nerve (19.6%). In total [Figure 1], good awareness level
regarding glaucoma was found among 725 participants (46.4%).
The mean score was 10.8 points out of 19 points.
Distribution of population awareness regarding glaucoma based
on their personal data and practice is presented in Table 3. Good
awareness level was found among 64.9% of the participants
who reported doctors as the main source of their information,
compared to 42% who reported the main source as friends.
This was statistically significant (P = 0.001). Also, 53.2% of the
participants who immediately seek for medical consultation in
case of eye problems had good awareness level, compared to
38.7% who wait for 2 days (P = 0.001). Good awareness level was
recorded among 57.1% of respondents who did screening for
glaucoma, compared to 45.8% of those who did not (P = 0.042).
Discussion
The main objective of this study is to assess the level of
awareness and knowledge of glaucoma in the general population

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 Alamri, et al.: Glaucoma awareness among the people of southern Saudi Arabia

Table 2: Awareness of the sampled population regarding glaucoma in Aseer region, Saudi Arabia
Awareness items No. %
Did you ever hear about glaucoma? 1205 77.1
Do you believe that glaucoma should be treated early? 1511 96.7
Do you think regular check‑ups of eyes from age 40 is necessary to detect glaucoma early? 1228 78.6
Do you think glaucoma will lead to blindness? 1380 88.3
Do you think the blindness resulting from glaucoma can be treated? 672 43.0
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Do you think red eye is symptom of glaucoma? 441 28.2

Do you think that symptoms of glaucoma include eye pain? 813 52.0
Do you think nausea and vomiting is one of the symptoms of glaucoma? 275 17.6
Do you think headache and blurred vision is one of the symptoms of glaucoma? 1164 74.5
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Do you think glaucoma is an asymptomatic disease? 820 52.5

Do you think glaucoma is a hereditary disease? 500 32.0
Do you think chronic diseases like diabetes mellitus and hypertension are a risk factor of glaucoma? 1135 72.6
Do you think people more than 60 years of age are more susceptible to glaucoma? 1243 79.5
Do you think that surgeries or a previous eye injury is a risk factor of glaucoma? 718 45.9
Do you think farsightedness and severe nearsightedness are risk factors of glaucoma? 363 23.2
Dose early screening help avoid complications of glaucoma? 1359 86.9
Do you think the only treatment of glaucoma is surgical? 577 36.9
Do you think it is important to tell your doctor you have glaucoma to avoid medication that can exacerbate the glaucoma? 1399 89.5
Glaucoma results from?
Blurry lens 547 35.0
Damage of optic nerve 306 19.6
Do not know 710 45.4
Total score (mean±SD) 10.8±3.3

of Abha city. These results may have significant public health

consequences, as we found that awareness of this situation
in the Aseer region is not adequate enough. The findings of
our study showed that 46.4% of the respondents have good
knowledge regarding glaucoma, which is in line with the findings
of one study stated that.[6‑10] In our study, more than 90.0%
of the respondents did not go through the screening process
of glaucoma, which is in line with the study conducted in
Ghana[11‑14] which reported that about 94% of people identified
with glaucoma were not aware that they had the disease before
screening. In addition, the low level of understanding and
knowledge of glaucoma in this sample population could be due
to the limited or non‑existent group or country‑wide reporting
on glaucoma. Likewise, a cross‑sectional, facility‑based survey
recorded 41.2% of glaucoma awareness in Canada. Our findings
Figure 1: Overall awareness level regarding glaucoma among people
are matching with a study conducted in Germany, which showed
from Aseer region, Saudi Arabia
that relatives and friends are the major sources of information
regarding glaucoma.[15,16] 80% of the respondents were aware about the fact that the
glaucoma will cause blindness, which is in contrast to the
Like many other studies, we found no association between Indian study. [17]
age or gender and glaucoma awareness. However, a
connection was noted previously between an understanding Our study findings showed the awareness and information level
of glaucoma and a specific gender or age. The relationship of people from Aseer region about glaucoma. Since glaucoma
between gender norms and behavior and attitude is not fixed, recognition can lead to early detection, this is a very important
and varies with social, economic, and traditional factors. step in preventing glaucoma‑related blindness.
These findings are in line with the Indian study by Rewri
and Kakkar (2014).[17] In our study, respondents believed We propose continuous assessments regarding glaucoma, which
that blurry lens and damage of optic nerve caused glaucoma, may help us to identify potential gaps in patient knowledge.
which is in line with the findings of one study stated that. An Educational devices and constructive communication should be
interesting positive finding of our study was that more than used to inform patients. It is necessary to encourage both patients

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 Alamri, et al.: Glaucoma awareness among the people of southern Saudi Arabia

Table 3: Distribution of population awareness regarding glaucoma based on their personal data and practice
Personal data and practice Awareness level P
Poor Good
No. % No. %
Gender 0.976
Male 159 53.5 138 46.5
Female 679 53.6 587 46.4
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Age in years 0.097

18‑28 548 55.6 437 44.4
29‑39 175 52.4 159 47.6
40‑50 89 46.1 104 53.9
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>50 26 51.0 25 49.0

Source of information for glaucoma 0.001*
Doctor 99 35.1 183 64.9
Friends 295 58.0 214 42.0
Internet and social media 444 57.5 328 42.5
Duration till consulting physician in case of having eye problems 0.001*
Immediately 325 46.8 370 53.2
A day or two 377 58.4 269 41.6
After 2 days 136 61.3 86 38.7
Did you do screening for glaucoma before? 0.042*
Yes 36 42.9 48 57.1
No 802 54.2 677 45.8
P: Pearson χ2 test. *P<0.05 (significant)

and their family members to take part in health instruction
programs.
Conclusion
Current research evaluates the awareness and knowledge level of
residents of Aseer region about glaucoma. Good awareness level
regarding glaucoma was found among 725 (46.4%) respondents
and 53.6% of the respondents had poor awareness.
Acknowledgement
Mr. Muhammad Abid Khan is acknowledged for the statistical
support.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. Almushayqih MH, Alharbi OA, Almodameg SF, Rahim AMA,
Alei MM, AL‑Anaz AB. Awareness of glaucoma in the
central region of Saudi Arabia. Int J Pharm Res Allied Sci
2018;7:53‑7.
2. Salmon JF. Glaucoma. In: Riordan‑Eva P, Augsburger JJ.
editors. Vaughan and Asbury’s General Ophthalmology,
19e. McGraw‑Hill; New York, 2020. Available from: https://
accessmedicine.mhmedical.com/Content.aspx?bookid=218
6&sectionid=165517934. [Last accessed on 2022 Apr 21].
3. Anipindi G, Isukapalli V. A study of pediatric gynecological
problems in a tertiary hospital. IAIM 2018;5:64‑9.
4. Kingman S. Glaucoma is second leading cause of blindness
globally. Bull World Health Organ 2004;82:887‑8.
5. Budenz DL, Barton K, Whiteside‑de Vos J, Schiffman J,
Bandi J, Nolan W, et al. Tema Eye Survey Study Group.
Prevalence of glaucoma in an urban West African
population: The Tema eye survey. JAMA Ophthalmol
2013;131:651‑8.
6. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and
treatment of glaucoma: A review. JAMA 2014;311:1901‑11.
7. Bizuneh YZ, Tsega A, Admassu F. Awareness of glaucoma
and associated factors among adults in Gish Abay town,
Northwest Ethiopia. Clin Optom 2020;12:37‑43.
8. Leite MT, Sakata LM, Medeiros FA. Managing glaucoma in
developing countries. Arq Bras Oftalmol 2011;74:83‑4.
9. Rotchford AP, Kirwan JF, Muller MA, Johnson GJ,
Roux P. Temba glaucoma study: A population‑based
cross‑sectional survey in urban South Africa. Ophthalmology
2003;110:376‑82.
10. Hennis A, Wu SY, Nemesure B, Honkanen R, Leske MC,
Barbados Eye Studies Group. Awareness of incident
open‑angle glaucoma in a population study: The Barbados
eye studies. Ophthalmology 2007;114:1816‑21.
11. Otabil KB, Tenkorang SB, Mac AL, Otabil EA. Prevalence of
glaucoma in an eye clinic in Ghana. Russ Open Medical J
2013;2:0310.
12. Kingman S. Glaucoma is second leading cause of blindness
globally. Bull World Health Organ 2004;82:811‑90.
13. Nduaguba C, Lee R. Glaucoma screening: Current trends,
economic issues, technology, and challenges. Curr Opin
Ophthalmol 2006;17:142‑52.
14. Tsegaye M, Mulugeta A, Giorgis AT. Glaucoma awareness
and knowledge among adults in woliso town, South West
Ethiopia. J Clin Res Ophthalmol 2020;7:087‑090.

Journal of Family Medicine and Primary Care 6168 Volume 11 : Issue 10 : October 2022
 Alamri, et al.: Glaucoma awareness among the people of southern Saudi Arabia

15. Pfeiffer N, Krieglstein GK, Wellek S. Knowledge about
glaucoma in the unselected population: A German survey.
J Glaucoma 2002;11:458‑63.
16. Celebi ARC. Knowledge and awareness of glaucoma in
subjects with glaucoma and their normal first‑degree
Downloaded from http://journals.lww.com/jfmpc by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1A
WnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 05/03/2023
relatives. Med Hypothesis Discov Innov Ophthalmol
2018;7:40‑7.
17. Rewri P, Kakkar M. Awareness, knowledge, and practice:
A survey of glaucoma in north Indian rural residents. Indian
J Ophthalmol 2014;62:482‑6.

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