Optimizing glaucoma care in Ghana: a mixed-methods study of optometrists' practices, challenges, and capacity needs
1
Primary Care Ophthalmology, College of Medicine and Veterinary Medicine, Deanery of Clinical Sciences, University of Edinburgh, Old College-South Bridge, Edinburgh, Scotland, United Kingdom
2
Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
3
College of Optometry, University of Houston, Houston TX, United States
4
Department of Biological Sciences, Purdue University, West-Lafayette, IN, United States
5
Department of Medicine and Surgery, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Popul. Med. 2026;8(Supplement Supplement 1):A1772
ABSTRACT
BACKGROUND:
Early detection and timely intervention for glaucoma remain critical to preventing irreversible vision loss. The pivotal role of primary eye care providers can thus not be overlooked. Despite defined scope of practice, little is known about the nature of glaucoma care rendered by optometrists in real-world settings in Ghana. This study assessed the practice patterns, challenges, and improvement strategies in glaucoma care among optometrists in Ghana.
METHODS:
A cross-sectional study using a mixed-methods approach. Quantitative data on demographics, clinical practices, associated factors, perceived barriers, and recommendations for improved glaucoma care were collected from 293 licensed optometrists registered with the Ghana Optometric Association using a structured questionnaire (distributed both in-person and online via Microsoft Forms), yielding a response rate of 44.1%. Qualitative insights were obtained through semi-structured interviews with nine optometrists, selected using purposive stratified sampling.
RESULTS:
Most respondents had received formal training in glaucoma care through didactic courses and practical training in their completed degree programs. However, over one-third lacked standardized clinical care protocols. Clinical care centered on intraocular pressure measurement and optic nerve evaluation, with medical therapy as the primary treatment. Referrals were commonly triggered by poor treatment response (mainly based on IOP measurement) or advanced disease. The existence of clearly defined clinical protocols demonstrated a statistically significant association with increased provision of glaucoma care among optometrists (p = 0.008). Thematic analysis identified key challenges to the provision of glaucoma care, including patient noncompliance, financial barriers, and limited access to diagnostic tools. Recommended strategies for improvement included enhanced training, improved diagnostic infrastructure, and increased public education.
CONCLUSIONS:
Optometrists play a vital role in glaucoma care in Ghana. However, gaps in guideline awareness, protocol use, and diagnostic capacity remain. Strengthening training, equipping clinics, and promoting public education are essential to improving glaucoma care nationwide.
Early detection and timely intervention for glaucoma remain critical to preventing irreversible vision loss. The pivotal role of primary eye care providers can thus not be overlooked. Despite defined scope of practice, little is known about the nature of glaucoma care rendered by optometrists in real-world settings in Ghana. This study assessed the practice patterns, challenges, and improvement strategies in glaucoma care among optometrists in Ghana.
METHODS:
A cross-sectional study using a mixed-methods approach. Quantitative data on demographics, clinical practices, associated factors, perceived barriers, and recommendations for improved glaucoma care were collected from 293 licensed optometrists registered with the Ghana Optometric Association using a structured questionnaire (distributed both in-person and online via Microsoft Forms), yielding a response rate of 44.1%. Qualitative insights were obtained through semi-structured interviews with nine optometrists, selected using purposive stratified sampling.
RESULTS:
Most respondents had received formal training in glaucoma care through didactic courses and practical training in their completed degree programs. However, over one-third lacked standardized clinical care protocols. Clinical care centered on intraocular pressure measurement and optic nerve evaluation, with medical therapy as the primary treatment. Referrals were commonly triggered by poor treatment response (mainly based on IOP measurement) or advanced disease. The existence of clearly defined clinical protocols demonstrated a statistically significant association with increased provision of glaucoma care among optometrists (p = 0.008). Thematic analysis identified key challenges to the provision of glaucoma care, including patient noncompliance, financial barriers, and limited access to diagnostic tools. Recommended strategies for improvement included enhanced training, improved diagnostic infrastructure, and increased public education.
CONCLUSIONS:
Optometrists play a vital role in glaucoma care in Ghana. However, gaps in guideline awareness, protocol use, and diagnostic capacity remain. Strengthening training, equipping clinics, and promoting public education are essential to improving glaucoma care nationwide.
| eISSN: | 2654-1459 |
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