The Glaucoma Network

Background

Glaucoma is the second most common cause of blindness worldwide. People with untreated glaucoma suffer from irreversible, progressive loss of sight. The disease is characterised by progressive loss of visual field, with pathological cupping of the optic disc and often (but not always) increased pressure in the eye. Early stages affect the field of vision and are often not noticed by the patient. The final stage is irreversible absolute blindness. Glaucoma treatment is primarily to lower the intraocular pressure to a ‘safe’ level through eye drops and/or laser treatment and/or surgical interventions. The highest prevalence and incidence of glaucoma exists in Sub-Saharan Africa and the Caribbean.

The Challenge

The key requirements to tackle glaucoma blindness in these regions are early identification of people with glaucoma and effective long-term treatment.

Addressing the Challenge

The Glaucoma-NET aims to improve the care of patients with glaucoma in low- and middle-income (LMICs) populations. This will be achieved by an International Partnership which invests in People, (those providing eye care and in particular glaucoma services), and Knowledge (the development and wide dissemination of evidence and best practice).

The Glaucoma-NET started in April 2021. In monthly meetings since then, the network has had attendees from the following countries: Burkina Faso, Cameroon, Canada, Ethiopia, Gambia The, Ghana, Germany, Kenya, Mozambique, Nigeria, South Sudan, Tanzania, Uganda, UK

Overall Aim

The aim of the Glaucoma-NET is preserving sight of people with glaucoma.

Objectives

The objectives of the Glaucoma-NET are:

  • to develop meaningful partnerships between glaucoma centres in high/middle/low-income countries,
  • to share knowledge on best practice between clinicians, centres and countries,
  • to agree shared guidelines and protocols,
  • to develop specific 3-year action plans (revolving) to improve glaucoma screening and treatment services.

Activities

1. Best Practice Toolkit

Finalise and adopt a “Toolkit for Glaucoma Management in Africa” which is appropriate for LMICs and adaptable for each specific country and context.

2. Training and Planning Workshops

Online or face to face workshops with knowledge sharing and planning of programmes

3. Continuing Professional Development / Certification

Offer CPD with points / certification in diagnostic skills, treatment modalities, programme planning and public engagement. This includes Glaucoma Simulator Surgical Skills training. Liaise with the proposed online Glaucoma Course from ICEH

4. Centre Twinning / Partnerships

One-to-one LINK clinical observerships with reciprocal exchange visits by 2 partner teams.

5. Glaucoma Decision-Intervention Support Cluster (The Glaucoma DISC)

Clinical and programmes decision support – This involves monthly virtual meetings and an interactive online international knowledge-sharing members-only website.

6. Train the Trainers’

This will ensure that the glaucoma ophthalmologists in the LINKS are able to train the next generation of glaucoma specialists in their countries.

7. Collaborative Multi- Country Research

The network will provide a foundation for multi-centre and multi- country research in glaucoma to generate evidence for new interventions for the early diagnosis and optimal treatment of glaucoma in LMICs.

8. Advocacy for improved resources for glaucoma care

Collaborate with other glaucoma and eye health groups worldwide in advocacy. Making medicines and laser equipment available; glaucoma patient groups, etc

 

Leadership, Management and Coordination

The overall strategy and activities of the Glaucoma-NET will be overseen by a Steering Group which will include:

1. The VISION 2020 LINKS Programme team will provide management oversight, monitoring/reporting support, administrative support and IT/data management.

2. Academic and technical input will be provided by an international team of glaucoma specialists: Fatima Kyari (Team Lead), Winnie Nolan, Heiko Philippin and Dan Kiage.