Data collected during a population-based general ophthalmic prevalence survey among Alaska's northwestern Eskimos were analyzed to determine the prevalence of glaucoma. Of the 1686 Eskimos examined, 11 cases (0.65%) of glaucoma were found, including ten cases of angle closure glaucoma (both chronic and acute forms) and a single case of open angle glaucoma. This indicates the rarity of open angle glaucoma in Eskimo eyes and a reversal of the typical pattern found in the general US population. Narrow angle glaucoma occurred at a rate of 2.65% in Eskimos older than 40 years of age, the prevalence increasing with age in both sexes. Women were afflicted almost four times as often as men, and the sex difference persisted across all age groups. Anterior chamber angles appeared clinically narrower with age and among women. Seventeen percent of all Eskimos older than 50 years had occludable angles by gonioscopy. These findings target older Eskimo women as a group particularly at risk for angle closure glaucoma.
The efficacy of a small, portable, battery-operated, Q-switched neodymium-YAG laser with a slit-lamp delivery system was evaluated in a short-term pilot study. Iridotomies were created in 44 Eskimo eyes (23 patients) with occludable angles in Alaska's Kotzebue region. The laser was transported as regular baggage, was used in three villages (utilizing available facilities), and was operational within five minutes. Patent iridotomies were achieved in all eyes and with one pulse in 18 eyes (44%). Complications included transient bleeding from the iridotomy site in 23 eyes (52%), focal corneal opacities in 11 eyes (25%), and a transient immediate postoperative intraocular pressure elevation in nine eyes (20%). This appears to be the first portable laser system that can be used in frontier areas and underdeveloped nations to prophylactically treat pupillary-block glaucoma.
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