Ophthalmology Section
DOI: 10.7860/JCDR/2022/59381.17024
Original Article
Knowledge, Attitude and Practice in Medical
Management of Glaucoma: A Cross-sectional
Study from a Tertiary Care Hospital
at Uttarakhand, India
priyanka gupta1, vatsala vats2, ashish kakkar3, aeshvarya dhawan4, tarannum shakeel5, monika jain6
ABSTRACT
Introduction: Glaucoma is most common cause of irreversible
blindness in the world. Hence, awareness about the disease,
importance of drugs effect and its side-effects and accurate
method of eye drop instillation is very crucial.
Aim: To assess Knowledge, Attitude and Practice (KAP) at the
medication, doctor and patient level in clinical practice.
Materials and Methods: It was a cross-sectional, descriptive,
questionnaire based study conducted at Shri Guru Ram
Rai Institute of Medical and Health Sciences, Dehradun,
Uttarakhand, India, for duration of two years from July 2020 to
June 2022. It included 290 patients diagnosed with glaucoma.
They were asked to demonstrate method of instillation of eye
drop to assess correct method and to cover a few aspects of
questionnaire regarding medication instillation. The statistical
analysis was done using Statistical Package for the Social
Sciences (SPSS) software version 21.0. The p-value was
determined for questions in the questionnaire using Chi-square
test. The p-value <0.05 was considered significant.
Results: About 88 (30.34%) patients were educated about the
nature and progression of glaucoma. Punctal occlusion was
explained to 40 (13.79%) patients and assisted instillation to
25 (8.62%) patients. Approximately 62 (70.45%) patients were
educated about their disease. About 244 (84.14%) patients
noticed that their ophthalmologist clinic had a television in
Outpatient Department (OPD). Family screening was advised in
only 67 (23.1%) of the patients. Only 53 (18.28%) patients were
emphasised on strict control of associated systemic illness.
Conclusion: Proper patient education about glaucoma and
treatment by healthcare provider plays a crucial role. Most of
the patients were not educated about method of instillation
of drops. Correct instillation of drops was crucial to achieve
target Intra Ocular Pressure (IOP), minimising side-effects and
reducing the cost of treatment. Family screening and control of
associated systemic conditions were often missed by majority
of ophthalmologists however, it is important to keep in mind.
Keywords: Awareness, Eye drop instillation, Screening, Topical antiglaucoma medications
introduction
Glaucoma is a chronic progressive optic neuropathy, associated
frequently but not always with raised IOP. There is plethora of
topical medications in the form of eye drops in armamentarium for
glaucoma treatment. Several new drugs like Rho-kinase inhibitors
are in pipeline showing promising results to lower IOP [1,2]. In spite
of this fact, the burden of blindness due to glaucoma in India has
increased from 60 million in 2010 to 80 million in 2020 [3]. Previously
there are studies done to see compliance of topical Antiglaucoma
Medications (AGM) [4,5]. However, considering the rising graph of
glaucoma, it is time to take a pause and reinforce compliance not
just at the level of medication but also factors at the patient and
doctor level. Awareness and understanding about the disease,
its pathogenesis and course helps the patient to be more alert
about the disease. A good communication between the treating
ophthalmologist and patient explaining the importance of drugs
effect and side-effects, proper timings, accurate method of eye
drop instillation is very crucial. Apart from treating IOP which is the
major modifiable risk factor there are other aspects like associated
hypertension, diabetes, migraine, obstructive sleep apnoea,
migraine etc. which hasten the disease progression [6-10]. These
conditions have to be kept in consideration while treating glaucoma.
These facts have been well known but not being incorporated in
day to day practice, especially by comprehensive ophthalmologists.
Importance of family screening and controlling co-morbid systemic
conditions which increases optic neuropathy has not been touched
in other papers in the literature.
Journal of Clinical and Diagnostic Research. 2022 Nov, Vol-16(11): NC01-NC06
Present study re-enforced the need to understand and give
appropriate attention to the under looked issue of eye drop
instillation. Thus, the aim of study was to analyse the accurate KAP
at medication, doctor and patient level, which can play a pivotal role
in bringing down the burden of glaucoma.
MATERIALS AND METHODS
It was a cross-sectional, descriptive, questionnaire based study
conducted at Shri Guru Ram Rai Institute of Medical and Health
Sciences, Dehradun, Uttarakhand, India, for duration of two years
from July 2020 to June 2022. Ethical clearance was obtained from
Institutional Ethical Committee (IEC) ECR/710/Inst/ UK/2015/RR18 (Reference no. SGRR/IEC/43/18) and adhered to the tenets of
the Declaration of Helsinki. The informed consent of subjects was
obtained. The identity of subjects had not been revealed anywhere
in the study. All the COVID-19 protocols and safety measures were
followed during patient handling.
Inclusion criteria: Subjects included the diagnosed cases of primary
and secondary open angle glaucoma, primary and secondary angle
closure glaucoma, taking treatment in same hospital/ elsewhere
and administering topical AGM for atleast past one month, subjects
who successfully filled the questionnaire and who gave informed
consent were included in the study.
Exclusion criteria: Patient using topical AGM for less than one
month were excluded (as the few aspects of the questionnaire
related to attitude and practice of patients could not be assessed
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Priyanka Gupta et al., KAP Gap in Medical Management of Glaucoma
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with such a short duration of treatment), patients not willing to
participate in the study were excluded from the study.
Sr.
No.
Confidence level=95%, Precision (d)=±2.25%, Formula used: n= (Z a
x P x (1-P))/d2 Where,
Za=Value of standard normal variate corresponding to a level of
significance, P=Likely value of parameter,Q= 1-P,d= margin of errors
which is a measure of precision. With these assumptions the sample
size calculated was 260. finally 290 patients were taken for study.
The previous works of literature were searched using PubMed and
Google Scholar on the available KAP questionnaires. Relevant
articles using the search were picked up. All the articles were
reviewed by the departmental glaucoma experts and the items for
the questionnaire were developed [12-15]. The experts had more
than 10 years of experience (clinical, research, and teaching) in field
of ophthalmology. After validating the questionnaire by Cronbach
coefficient alpha (rkα=0.803), the experts finalised 20 questions,
addressing factors related to the patient, medication and physician
for the current study. Subjects were asked to respond to the
questionnaire drafted.
In the present study, six aspects in view of knowledge of patients
about their disease were considered in the questionnaire. It was
enquired whether patients were educated about nature and
progression of disease and who imparted this education. Patients
were enquired if they were educated about timing of instillation of
drops and correct method of instillation of drops, including punctal
occlusion and assisted instillation. Two aspects were assessed to
know the attitude of patients regarding their disease. They were
enquired if they understood the nature, progression and effect of
disease. They were asked whether or not they understood the
importance of method of instillation of drops. Seven aspects were
analysed to ascertain the gap at patient level with regard to visits to
the treating eye doctor and instilling eye drops. Five questions were
included pertaining to practice of treating ophthalmologist.
Patients not carrying their past glaucoma treatment records were
asked to show records on subsequent visit. Their record papers
were analysed to fill a few responses of questionnaire pertaining to
role of clinician in glaucoma diagnosis. After filling the questionnaire,
the patients were taken to a designated room in the OPD. The
facilities for washing of hands, availability of mirror and couch
for lying down or sitting were available. Patients were asked to
instill eye drops using a bottle of sterile Carboxy Methyl Cellulose
(CMC 0.5%) in either of the eye depending on patient preference.
This was done to check the method of instillation of AGM. If the
method demonstrated by the patient was wrong then the doctor
demonstrated the correct method of instillation. Firstly, the patients
were advised to wash hands properly before instilling drops and
then pouring a single drop on retracting the Cul de sac followed by
performing punctal occlusion for 10-20 seconds [Annexure].
RESULTS
A total of 290 participants were included in the study as they were
able to completely fill the questionnaire. The age of the patients in
the study ranged from 18-80 years. There were 125 (43.1%) males
and 165 (56.9%) females in the study. The female to male ratio was
1.3:1. Results of study have been tabulated in [Table/Fig-1]. In the
present study, six aspects in view of knowledge about their diseases
2
p-value*
Educated about nature and progression of disease (n=290)
1.
(a) Yes
88
30.34
(b) No
202
69.66
(a) By doctor
211
72.76
(b) By trained staff
79
27.24
<0.001
Educated by whom (n=290)
2.
<0.001
Educated about timing of instillation of drops (n=290)
3.
(a) Yes
221
76.20
(b) No
69
23.80
<0.001
Educated about method of instillation of drops (n=290)
4.
(a) Yes
65
22.41
(b) No
225
77.59
(a) Yes
40
13.79
(b) No
250
86.21
<0.001
Punctal occlusion informed (n=290)
5.
<0.001
Assisted instillation informed (n=290)
6.
(a) Yes
25
8.62
(b) No
265
91.38
<0.001
Attitude
Did you understand your disease as told by your doctor/ staff (n=88)
1.
(a) Yes
62
70.45
(b) No
26
29.55
<0.001
Did you understand the importance of method of instillation of drops
(n=65)
2.
(a) Yes
58
89.24
(b) No
7
10.76
<0.001
Practice
Do you visit your ophthalmologist on the dates advised (n=290)
1.
(a) Yes
179
61.72
(b) No
111
38.28
<0.001
Do you follow the proper timing of instillation of eye drops as explained
by your ophthalmologist (n=221)
2.
(a) Yes
154
69.68
(b) No
67
30.32
(a) Yes
9
22.5
(b) No
13
32.5
(c) Sometimes
18
45.0
<0.001
Do you perform punctal occlusion (n=40)
3.
<0.001
How frequently do you miss your drops (n=290)
4.
(a) Once a week
22
7.59
(b) Once in 15 days
179
61.72
(c) Occasionally
89
30.69
<0.001
How frequently do you get your IOP checked (n=290)
STATISTICAL ANALYSIS
All the responses were entered on a Microsoft excel sheet (windows
10) and tabulated. Percentages were calculated as (number of
response/total number of subjects) X 100. The statistical analysis
was done using SPSS software version 21. The p-value was
determined for questions in the questionnaire using Chi-square test.
The p-value <0.05 was considered significant.
%
Knowledge
Sample size calculation: It is assumed that the prevalence rate of
glaucoma is 3.54% from the previous study [11].
2
Response
in number
Question
5.
(a) Monthly
24
8.28
(b) 3 monthly
163
56.21
(c) 6 monthly
47
16.21
(d) Yearly
12
4.14
(e) Not regular
44
15.16
<0.001
Were you asked to demonstrate the method of instilling drops (n=290)
6.
(a) Yes
40
13.79
(b) No
250
86.21
<0.001
Method of eyedrop instillation (n=290)
7.
(a) Self instillation
218
75.17
(b) Assisted instillation
50
17.24
(c) Mixed
22
7.59
<0.001
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Priyanka Gupta et al., KAP Gap in Medical Management of Glaucoma
Role of clinician
Does your doctor has a TV in OPD (n=290)
1.
(a) Yes
244
84.14
(b) No
30
10.34
(c) Didn’t notice
16
5.52
<0.001
Does your ophthalmologist run any educative video about eye disease
in his/her clinic/ hospital (n=244)
2.
(a) Yes
20
8.20
(b) No
224
91.80
(a) Yes
67
23.10
(b) No
223
76.90
<0.001
Family screening advised (n=290)
3.
<0.001
Systemic illness considered and emphasized to control (n=290)
4.
(a) Yes
53
18.28
(b) No
237
81.72
<0.001
[Table/Fig-1]: Showing knowledge, attitude and practice of the subjects.
*Chi- square test
were considered in the questionnaire, only 88 (30.34%) patients were
educated about the nature and progression of glaucoma. About
65 (22.41%) patients were educated about the correct method of
instillation of eye drops and 221 (76.20%) were aware that timing
of instillation of eye drops has a role to play. About 211 (72.76%)
confirmed that knowledge about glaucoma was given to them by
the ophthalmologist. Regarding the correct method of instillation of
eye drops, punctal occlusion was explained by the treating doctor
to 40 (13.79%). About 25 (8.62%) had information regarding
assisted instillation of AGM. Approximately 70.4% patients (62
patients out of 88 patients who were educated about their disease)
understood about glaucoma when they were informed by doctor
or staff. 89.24% patients (58 subjects out of 65 patients who were
explained about correct method of instillation) had understanding
about importance of correct method and appropriate timing of
instillation of eye drops. Rest of the subjects neither did understand
nor bothered to ask again.
In the study, 179 (61.72%) patients visited the treating ophthalmologist
on advised dates. In the present study, out of 221 patients who were
explained about the importance of timing of instillation of eye drops,
154 (69.68%) patients were instilling eye drops as advised. Out of
those 40 patients in knowledge who were educated about punctal
occlusion, 13 (32.5%) were not performing it while instilling the antiglaucoma eye drops and 9 (22.5%) performed punctal occlusion
each time. In present study, 22 patients (7.59%) missed their antiglaucoma eye drops once a week.
Out of total 290 patients, only 40 (13.79%) were asked to
demonstrate the correct method of instillation of drops on
subsequent visit to their ophthalmologist. On discussing about
the method of instillation of AGM, it was found that 218 (75.17%)
were self-administering drops, 50 (17.24%) were assisted by
some care giver for instilling eye drops and rest 22 (7.59%) were
instilling eye drops sometimes by themselves and sometimes by
assisted method, depending on availability of helper. In the study,
24 patients got their IOP checked every month, 163 patients 3
monthly; 47 patients 6 monthly and 12 patients yearly respectively.
The study showed that 44 patients were getting IOP checked at
random interval as per their convenience. On observing the patients
while instilling eye drop in dedicated examination room, various
difficulties faced by patients in instilling eye drops in decreasing
order included extra drop expression in 73% , eye-tip touch in
61%, dose forgetfulness in 43%, difficult targeting in 34%, difficult
squeezing in 29% and difficult capping in 19% patients.
Five questions were included in questionnaire to find out the
practice methodology of ophthalmologist in diagnosing and
treating glaucoma. About 244 (84.14%) patients noticed that there
Journal of Clinical and Diagnostic Research. 2022 Nov, Vol-16(11): NC01-NC06
was a television installed in waiting area of their ophthalmologist’s
clinic. However, out of those 244 subjects, only 20 (8.2%) patients
stated that educative video about eye diseases were played on
television. The investigations which were used to make diagnosis of
glaucoma as seen in patient’s records in the study included IOP in
100% patients, slit lamp examination in 100%, fundus examination
in 87%, Optical Coherence Tomography (OCT) in 77%, perimetry
in 32% and gonioscopy in 10% patients, respectively. Only 23%
patients (67 patients) were told about the importance of family
screening. Family screening was missed in 223 (76.90%) of the
cases in present study. In this study, 53 (18.28%) patients were
informed about their systemic illness and its relation to occurrence
of glaucoma and its control. Nearly 237 (81.72%) patients in
present study were not being paid attention to related co-morbid
systemic illness.
Discussion
Various treatment modalities are available for the treatment of
glaucoma; topical AGM being the first line therapy, followed by laser
or surgical treatment in specific cases [16]. With the effective use
of medical therapy, vision loss in patients with glaucoma can be
prevented [17]. The three important constituents of a successful
topical pharmacotherapy are adherence, persistence and correct
administration of eye drops by the patients [18]. However, this is
possible only if the patient is inclined towards treatment. Patient
motivation is possible through proper education, which requires a
good counselling from the healthcare provider. Thus, it is important
to reconsider the loop hole at each level in our day to day clinical
glaucoma practice.
In present study, only 30.34% patients were educated about
glaucoma, which was low as compared to one of the study where
98% of the patients had knowledge about the disease [19]. The
reason for high prevalence in referred study was because the patients
were dealt by glaucoma specialist who naturally emphasises more
on the disease as compared to patients treated by comprehensive
ophthalmologist in present study. India is a country where glaucoma
is treated by general ophthalmologist as much as by glaucoma
specialists. In the present study, out of those who were educated
about the disease 89.24% understood what condition they were
dealing but 10.76% till failed to understand in the first visit. Thus, it
indicates that the patients should be reinforced and educated about
the disease on every visit or atleast frequently, if time constraints are
there due to high patient load.
The patient compliance increases if he/she understands the
silent nature of disease progression. In present study, mostly the
treating ophthalmologist educated the patient about the disease,
the importance of the correct method and appropriate timing of
instillation of eye drops. In few cases, trained staff imparted the
knowledge. Educating and motivating the glaucoma patients to
instil timely eye drops is a very crucial but on the other hand very
tedious task. It involves cooperation and judicious time of treating
doctor. As there is more patient load on the doctor, so meticulously
training their staff to spend time with the patient, explaining them
disease nature and course is also a good alternative for the doctor.
This will reduce burden and thus enhancing the efficiency of the
doctor without compromising the purpose to bridge the education
and motivation gap.
In present study, punctal occlusion was informed to only 13.79%
patients. Out of those informed only 22.5% (9 patients) performed
it every time. Large proportion (13 not performing punctal occlusion
at all and 18 sometimes doing punctal occlusion) despite being
informed didn’t practice it. Similar observation was seen in study by
Gupta R et al., which concluded that nearly out of 10 people were
not able instil the eye drop correctly [20]. Punctal occlusion causes
the drug to remain for a longer duration in the eye. So its effect
lasts longer thus reducing IOP effectively. Also the drug does not
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Priyanka Gupta et al., KAP Gap in Medical Management of Glaucoma
reach systemic circulation, thereby reducing side-effects. In some
studies, correct method of instillation of eye drop was not explained
to the patients [21,22]. Studies suggest that there should be more
education of eye drop instillation technique [20,23]. Compliance
is better ensured if they are told about side-effects beforehand
as few patients discontinue eye drop because of side-effects like
hyperaemia and grittiness [24].
In this study, 75% patients were administering eye drops by
themselves. Common issues reported by patients in this study
included extra drop expression, difficult targeting, difficult
squeezing, eye tip touch, difficult capping and forgetting doses.
Similar problems have been addressed in other studies too [25,26].
Touching the eye and lid with the tip of bottle is a problem as it
may be a source of contamination of bottle [27-29]. Cost of AGM is
an important hindrance in long-term compliance. Moreover, proper
usage of drops may be pocket friendly to the patient. To minimise
all these difficulties, patients should be demonstrated about the
correct method of instilling eye drops. For proper implementation of
this practice, patient should be reinforced by asking to demonstrate
the method at every subsequent visit [30].
A few percent, 8.62% of subjects had knowledge about assisted
eye drop instillation in present study. Glaucoma, once diagnosed
puts a physical, mental, financial and social burden too. Based
on patient’s age, visual status, general health, cognition and
comprehensive level, the concept of assisted instillation of
eye drop has been widely recommended and followed [31].
Therefore, family members should be motivated to support the
patient in dealing with the disease. Accompanying attendant
should be encouraged during counselling sessions to assist in
instillation of eye drops. Large number of studies has shown faulty
practice of self instillation of eye drop [20,25,32,33]. While many
patients claiming to have no difficulty in instilling drops are often
unaware of faulty techniques [25]. A study has clearly stated that
10% glaucomatous blindness was due to poor compliance [34].
Faulty instillation of eye drops may result in failure to reach target
IOP. This therapeutic under effect leads to addition of add on
eye drops. It adds up to the local and systemic side-effects as
well as cost of treatment [35]. Thus, present study highlighted the
importance of repeated demonstration of method of instillation of
topical AGM at each visit.
Other important determinant of compliance of AGM included
skipping of drop. The frequency of missing eye drops was variable
in this study. These have been reported in previous studies also
[19,27]. Poor compliance results in therapeutic failure. In present
study, 61.7% patients visited ophthalmologist on the dates advised
for follow-up, thus estimating the compliance of patient. Proper
counselling, education and reinforcement at every visit are crucial
for ensuring regular and timely follow-ups.
Education could be spread by newspapers, radio, or educative
videos [36]. It has been observed in present study as well as day
to day OPD visits in various clinics that most of the setups had
television (T.V). It generally displays entertainment videos for time
pass of waiting patients. Educative videos about eye diseases
should be encouraged in OPD through television sets. A lot of myths
can be eliminated through education especially in our society and
country where myths are readily and powerfully accepted.
There are many subsets of investigations which are performed in
glaucoma patients. IOP measurement, slit lamp examination and
dilated fundus examination were one in almost all the cases in which
glaucoma is suspected. As illustrated in this study, gonioscopy
had been done in 10% patients only. Gonioscopy should be done
in all suspected and established glaucoma cases. It is a helpful
tool in diagnosing secondary glaucoma such as following blunt
trauma which is often missed during routine glaucoma work-up
due to incomplete history. Performing gonioscopy requires good
expertise on part of clinician and is not patient friendly. Thus, it is
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easily skipped during examination for making diagnosis by general
ophthalmologist. Though basic and essential, yet its importance
is fading off in clinical practice. Gonioscopy as an OPD procedure
should not be underestimated [37].
Glaucoma is a disease that runs in families [6]. First degree relatives
are most commonly affected [7]. Open angle glaucoma is more
common so majority of patients are asymptomatic. Therefore, hidden
cases need to be identified to decrease the burden of disease. Thus,
family screening plays a very pivotal role in this regard. However, it
missed in 77% of the cases in present study.
Systemic control of associated illnesses is an underestimated but
a key for proper control of IOP. The risk factors contributing to
glaucoma include hypertension, diabetes mellitus, cardiovascular
disease, migraine, obstructive sleep apnoea etc [6-10]. So, not only
treating the eye but treating the whole body is also an essential
prerequisite for controlling optic neuropathy in glaucoma. Most of
the cases, nearly 81.72% patients in present study were not being
paid attention to related co-morbid systemic illness. Thus, special
emphasis is to be made in controlling those relatable factors that
influence the management of glaucoma.
Limitation(s)
Patient’s compliance to drops was assessed using a questionnaire,
so the response was subjective. In addition, bias may have been
introduced as patient tends to be more cautious while instilling
drops in presence of a doctor in the examination room. Education
level of the patient was not taken into account, which might have
a role to play in the better understanding and compliance towards
AGM and disease as a whole.
CONCLUSION(S)
In the present study only 30.34% patients were educated about
the nature and progression of glaucoma. About 70.45% patients
understood about glaucoma when they were informed by doctor
or staff, 69.68% patients were instilling eye drops as advised. Only
23.10% patients were told about the importance of family screening.
Proper method and timely instillation of drops is crucial to achieve
target IOP, minimising side-effects, retarding optic neuropathy and
reducing the cost of treatment.
Prospectively an extensive assessment of comprehensive
ophthalmologist’s and ophthalmologist practicing glaucoma as a
speciality can be done regarding the knowledge and attitude of the
disease which will surely be beneficial to bring out shortcomings in
the practice.
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PARTICULARS OF CONTRIBUTORS:
1. Assistant Professor, Department of Ophthalmology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
2. Associate Professor, Department of Ophthalmology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
3. Associate Professor, Department of Ophthalmology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
4. Fellow, Department of Ophthalmology, Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India.
5. Professor, Department of Ophthalmology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
6. Assistant Professor, Department of Ophthalmology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.
NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Aeshvarya Dhawan,
Doctors Hostel, Sitapur Eye Hospital, Sitapur-261001, Uttar Pradesh, India.
E-mail: aeshvarya.dhawan@gmail.com
PLAGIARISM CHECKING METHODS: [Jain H et al.]
• Plagiarism X-checker: Aug 05, 2022
• Manual Googling: Oct 10, 2022
• iThenticate Software: Oct 11, 2022 (4%)
Author declaration:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
Etymology: Author Origin
Date of Submission: Jul 29, 2022
Date of Peer Review: Aug 24, 2022
Date of Acceptance: Oct 12, 2022
Date of Publishing: Nov 01, 2022
[ANNEXURE]
NameAge/genderDuration of disease- duration of disease was noted as we have taken only those patients who have been taking topical eye drops for more
than a month. We have not analysed the duration of disease, as it is not a part of any aspect of knowledge, attitude or practice
Type of management- medical/ surgical/ both/ laser:
Family historySystemic illness
We have not analysed the demographic and clinical aspects of patients. These questions were asked for completion of patient data only.
Questions following ahead this section have only been analysed.
Knowledge
1.
Educated about nature and progression of disease
2.
By whom
3.
Educated about timing of instillation of drops
(a) YES
(a) BY DOCTOR
(a) YES
(b) NO
(b) BY TRAINED STAFF
(b) NO
Journal of Clinical and Diagnostic Research. 2022 Nov, Vol-16(11): NC01-NC06
5
Priyanka Gupta et al., KAP Gap in Medical Management of Glaucoma
4.
Educated about method of instillation of drops
5.
Punctal occlusion informed
(a) YES
(b) NO
(a) YES
6.
www.jcdr.net
(b) NO
Assisted instillation informed
(a) YES
(b) NO
Attitude
1.
Did you understand your disease as told by your doctor/ staff
2.
Did you understand the importance Of method of instillation of drops (a) YES
(a) YES
(b) NO
(b) NO
Practice
1.
Do you visit your ophthalmologist on the dates advised
(a) YES (b) NO
2.
Do you follow the proper timing of instillation of eyedrops as explained by your ophthalmologist
(a) YES (b) NO
3.
Do you perform punctal occlusion
(a) YES (b) NO (c) SOMETIMES (d) MOSTLY
4.
How frequently do you miss your drops
(a) once a week
(b) Once in 15 days
(c) Occasionally
5.
How frequently do you get your IOP checked
(a) monthly
(b) 3 monthly
(c) 6 monthly
(d) yearly (e) not regular
6.
Were you asked to demonstrate the method by which you are instilling drops (a) YES (b) NO
7. Method of eyedrop instillation (a) self instillation (b) assisted instillation (c) mixed
Role of clinician
1.
Does your doctor has a TV in OPD
2.
Does your ophthalmologist run any educative video about eye disease in his/her clinic/ hospital
3.
What all investigations were used to make diagnosis
(a) YES
(a) YES
(b) NO
(c) didn’t notice
(b) NO
(a) IOP
(b) Fundus
(c) Perimetry
(d) Gonioscopy
(e) Slit lamp examination
(f) OCT
4.
Family screening advised
(a) YES
5.
Systemic illness considered and emphasized to control
(a) YES
6
(B) NO
(b) NO
Journal of Clinical and Diagnostic Research. 2022 Nov, Vol-16(11): NC01-NC06