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 Table of Contents  
Year : 2020  |  Volume : 58  |  Issue : 3  |  Page : 169-173

An innovative approach to create glaucoma awareness and its impact among the general population

Department of Glaucoma, Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Puducherry, India

Date of Submission23-Mar-2020
Date of Acceptance06-May-2020
Date of Web Publication14-Sep-2020

Correspondence Address:
Dr. Srinivasan Kavitha
Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Cuddalore Main Road, Thavalakuppam, Puducherry - 605 007
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_26_20

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Purpose: To create awareness about glaucoma through a novel exhibition and also to assess the impact of the same among the participants. Materials and Methods: An innovative three-dimensional click art exhibition was designed to create awareness about glaucoma among general public at Puducherry beach, during the World Glaucoma Week, 2019. The exhibition was also used to screen visitors for glaucoma, and a questionnaire-based survey was conducted to assess the impact of exhibition in creating glaucoma awareness. Results: Twenty thousand people visited the exhibition. A total of 2198 people were screened for glaucoma, of which 106 (4.8%) were found to be glaucoma suspects and were referred to the base hospital. Twenty-two out of 106 (20.75%) glaucoma suspects presented to the hospital during March 2019, of which 12 (54.5%) were confirmed to have glaucoma. A total of 531 people took up the 10-point questionnaire out of which 273 (50.1%) people answered eight or more questions correctly. Conclusion: Innovative approaches to create awareness about glaucoma can significantly aid in increasing the awareness and knowledge about glaucoma in general population.

Keywords: Glaucoma awareness, glaucoma knowledge, innovative exhibition, World Glaucoma Week

How to cite this article:
Kumar GP, Gayam K, Kavitha S, Venkatesh R. An innovative approach to create glaucoma awareness and its impact among the general population. TNOA J Ophthalmic Sci Res 2020;58:169-73

How to cite this URL:
Kumar GP, Gayam K, Kavitha S, Venkatesh R. An innovative approach to create glaucoma awareness and its impact among the general population. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2020 Oct 26];58:169-73. Available from: https://www.tnoajosr.com/text.asp?2020/58/3/169/294980

  Introduction Top

Glaucoma, infamously known as a silent thief of sight, is a leading cause of irreversible blindness in the world.[1] Globally, over 65 million people are currently affected by glaucoma, and this number is on rise to become 111.8 million by 2040.[2] In India, glaucoma accounts for 5.8% of overall burden of preventable blindness.[3] Fifty to ninety percent of glaucoma in the community goes undiagnosed, and the visual disability caused by glaucoma has a negative impact on moral, social, and economic well-being of an individual.[4],[5],[6]

Early detection and management of glaucoma can potentially slow down the progression, reducing the glaucoma-related visual disability.[7] Spreading knowledge about the risk factors, such as familial inheritance of glaucoma, may encourage more awareness. Early disease detection can be achieved by screening, either a population-based screening or through a high-risk screening. Population based screening for glaucoma is challenging as the prevalence of glaucoma in the general population is low. Also glaucoma screening is not a simple process as it involves complex tests.[8] However, without awareness about the disease and its blinding consequences, participation by the general public in these screening programs will not be much successful. Various studies have shown that awareness about glaucoma in general population in India is very poor ranging from 0.32% to 13.5%.[9],[10],[11] Hence, creating awareness about the disease in the community is essential for early disease detection and decreasing morbidity related to glaucoma. World Glaucoma Association celebrates the 2nd week of March, every year as World Glaucoma Week, to create awareness about glaucoma in the community. Activities such as marathon walk, magazines or newspaper articles, television programs, radio talks on glaucoma are utilized as a source to spread awareness. The influence of these activities may be short lived, and assessing the degree of awareness and knowledge created by these programs is difficult. Analyzing the impact created by the awareness program helps us to know whether the program really served the purpose.

In the year 2019, we tried a novel approach for creating glaucoma awareness during the “World Glaucoma Week” through a “Three-dimensional (3D) click art exhibition.” This exhibition was also used as a platform to screen participants for glaucoma and also utilized as an opportunity to assess the knowledge gained by the people from the novel exhibition through a questionnaire.

This article describes the innovative approach which was used to create glaucoma awareness and the impact of this approach in imparting knowledge about glaucoma to the general public.

  Materials and Methods Top

The study was conducted in accordance with the tenets of the Declaration of Helsinki. Written informed consents were taken from all those who were willing to participate in the survey. The exhibition was conducted by a team of doctors, nurses, and technicians from the base hospital.

During the period corresponding to the World Glaucoma Week, from March 9 to 17, 2019, a specially designed 3D click art museum or exhibition [Figure 1] was arranged at Puducherry Beach Road, a famous and one of the attractive tourist spots, and also one of the most common places for public gathering. Various 3D models and paintings were made and exhibited. Each painting and model had a message about glaucoma and its consequences if not identified and treated at right time. The paintings and models [Figure 2] were prepared on ecofriendly materials such as coconut tree leaves, rope mats, palm tree leaves, and cloth materials. The exhibition was made available for the public with zero entry fee, for a duration of 1 week from morning 10 AM till evening 8 PM. A team led by an ophthalmologist was present throughout the day to explain and answer the queries. Participants who were above 40 years of age and willing to undergo examination were screened for glaucoma. Basic eye examination was done using a portable slit-lamp by an ophthalmologist, intraocular pressure (IOP) measurement was done using a hand-held rebound tonometer (Icare ic 100, Tiolat Oy, Helsinki, Finland) by a nursing staff, optic disc photographs were taken using a non-mydriatic fundus camera (FOP-NM10, Remidio Innovative Solutions, India) by an ophthalmic technician, and visual field examination was performed using a portable, virtual reality-based field analyzer (CFA, Alfaleus Technology Pvt. Ltd., India) for disc suspects as and when recommended by the ophthalmologist. People needing further evaluation were referred to the base hospital.
Figure 1: Three-dimensional click art glaucoma awareness exhibition

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Figure 2: Three-dimensional arts and paintings made from ecofriendly materials with a message about glaucoma

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People who were interested and willing to participate in our survey, to assess the glaucoma knowledge gained from the exhibition, were requested to answer the survey questionnaire. Basic demographic details including age, gender, occupation, and educational status were collected. The questionnaire consisted of 10 questions, each with four choices out of which one was correct. The questionnaire was made available in both English and the regional language, Tamil [Annexure 1]. Once the participants completed the questionnaire, it was evaluated for the right answer by the ophthalmologist and was given a score of 1 for each right answer. Those who secured eight or more scores out of 10 were awarded with a plant sapling. Descriptive statistical analysis was done on the survey questions.

  Results Top

Over all twenty thousand people visited the exhibition during the seven days. A total of 2198 people underwent screening. A total of 106 (4.8%) people were diagnosed as glaucoma suspects, based on the IOP and optic disc changes, and were referred to the base hospital, of which 22 (20.75%) presented at base hospital within the same month for detailed glaucoma evaluation. The demographic details of these patients are shown in [Table 1]. Twelve patients were diagnosed to have glaucoma at base hospital. The break-up of the glaucoma diagnosis of these patients is shown in [Figure 3].
Table 1: Demographic details of the patients diagnosed with glaucoma at base hospital

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Figure 3: Breakup of glaucoma diagnosis among patients diagnosed with glaucoma at base hospital

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Survey results

Five hundred and thirty-one people participated in the survey, of which 273 (50.1%) answered eight or more questions correctly. The demographic details of the participants are shown in [Table 2]. The responses to the questionnaire by the participants are shown in [Figure 4].
Table 2: Demographic details of the survey participants

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Figure 4: Percentage of participants who gave correct answers for each question in glaucoma awareness questionnaire

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  Discussion Top

The innovative, attractive, and colorful awareness model was well received by the public with about 20,000 visitors. The place we chose to put up the exhibition was one of the most attractive tourist spots in Puducherry, where people from various places both nationally and internationally tend to visit commonly. The exhibition was able to impart awareness and knowledge about glaucoma to the visitors to a good extent that half of the participants who took the survey were able to answer eight of the ten questions correctly. We were able to convey, to a great extent, through the exhibition that glaucoma is a noncontagious disease, is referred to a condition having raised eye pressure, eye screening after 40 years of age is mandatory, and screening family members of glaucoma is essential [Figure 4]. Through the survey, we also found that we need to stress more on conveying the type of vision loss in glaucoma, its irreversible nature, and available treatment options.

Awareness and knowledge about a disease are the key steps for timely seeking of healthcare. Glaucoma being an asymptomatic disease and poor awareness often leads to late presentation.[9],[10] Lack of awareness is due to the absence, inaccessibility, or inaccuracy of information. Previous studies have shown that the knowledge about glaucoma among rural[7] as well as urban[7],[8],[9] South Indian population is poor. Using an innovative and interesting approach for educating the people and at the same time screening them for glaucoma with appropriate referral can help in early detection of glaucoma, preventing avoidable blindness.

We also noticed an interesting fact that visitors were very excited in taking selfies and group photographs with the 3D models, each of which had a message about glaucoma. We believe that these photographs will help in spreading the message about glaucoma in a long term, even after the World Glaucoma Week.

Our paper has certain limitations. The survey was conducted immediately after the people went through the exhibition; the same questionnaire if given before could have yielded more data on pre-existing awareness and knowledge about glaucoma. Although 20,000 people visited the exhibition, only 2.65% participated in the survey. All the people who took the survey had their education status of at least primary education or above. None of the illiterates participated in the survey, and hence, we were not able to analyze the impact of this exhibition on them. Level of awareness about glaucoma is expected to be higher among the first-degree relatives of patients with glaucoma. Collecting the details on glaucoma family history could have added additional information about its influence on awareness level.

Among those who underwent screening, 12 people were diagnosed with some form of glaucoma in the base hospital. Two of them were in their early forties. Glaucoma being an asymptomatic disease, we cannot be sure whether these people will ever present themselves for a screening.

  Conclusion Top

The novel innovative approach to impart glaucoma knowledge and create awareness among the people was well received by the public. We believe that the information from this article might motivate others to try out more such innovative, interesting approaches for creating long-lasting awareness about glaucoma. We believe that creating awareness among the general public in the long run will make a difference on the level of visual disability caused by asymptomatic glaucoma, through early diagnosis.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis. Ophthalmology 2014;121:2081-90.  Back to cited text no. 2
Jose R. Present status of the National Programme for Control of Blindness in India. Community Eye Health J 2008;21:103-4.  Back to cited text no. 3
Dandona L, Dandona R, Srinivas M, Mandal P, John RK, McCarty CA, et al. Open-angle glaucoma in an urban population in Southern India: The Andhra Pradesh eye disease study. Ophthalmology 2000;107:1702-9.  Back to cited text no. 4
Vijaya L, George R, Arvind H, Baskaran M, Paul PG, Ramesh SV, et al. Prevalence of angle-closure disease in a rural Southern Indian population. Arch Ophthalmol 2006;124:403-9.  Back to cited text no. 5
Parrish RK 2nd, Gedde SJ, Scott IU, Feuer WJ, Schiffman JC, Mangione CM, et al. Visual function and quality of life among patients with glaucoma. Arch Ophthalmol 1997;115:1447-55.  Back to cited text no. 6
Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E, et al. Factors for glaucoma progression and the effect of treatment: The early manifest glaucoma trial. Arch Ophthalmol 2003;121:48-56.  Back to cited text no. 7
Burr JM, Mowatt G, Hernández R, Siddiqui MA, Cook J, Lourenco T, et al. The clinical effectiveness and cost-effectiveness of screening for open angle glaucoma: A systematic review and economic evaluation. Health Technol Assess 2007;11:iii-iv, ix-x, 1-190.  Back to cited text no. 8
Krishnaiah S, Kovai V, Srinivas M, Shamanna BR, Rao GN, Thomas R. Awareness of glaucoma in the rural population of Southern India. Indian J Ophthalmol 2005;53:205-8.  Back to cited text no. 9
[PUBMED]  [Full text]  
Sathyamangalam RV, Paul PG, George R, Baskaran M, Hemamalini A, Madan RV, et al. Determinants of glaucoma awareness and knowledge in urban Chennai. Indian J Ophthalmol 2009;57:355-60.  Back to cited text no. 10
[PUBMED]  [Full text]  
Dandona R, Dandona L, John RK, McCarty CA, Rao GN. Awareness of eye diseases in an urban population in Southern India. Bull World Health Organ 2001;79:96-102.  Back to cited text no. 11


  [Figure 1], [Figure 2], [Figure 3], [Figure 4]

  [Table 1], [Table 2]


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