Management of ocular adverse reactions to antiglaucoma medications–Survey of optometrists in Ghana

Abstract

Glaucoma, characterized by chronic and progressive degeneration of retinal ganglion cells leading to a gradual decline in the visual field, poses a significant challenge in eye care delivery. Optometrists play a vital role in detecting and managing glaucoma. This study aims to determine how Ghanaian optometrists manage ocular adverse reactions (OADRs) in patients using antiglaucoma medications. A cross-sectional survey was conducted among 139 licensed optometrists using a pre-tested, semi-structured questionnaire. Data collected included socio-demographic characteristics, reported adverse reactions, and awareness of reporting or management protocols. Descriptive and inferential statistics were performed using SPSS version 25.0. Participants had a mean age of 31.6 ± 5.5 years and an average practice experience of 5.6 ± 4.5 years. Most respondents were female (71.2%), with 36.7% practicing in Greater Accra and 32.0% in private facilities. Nearly all participants (92.8%) reported encountering OADRs to AGMs. The most common symptoms were red eyes (36.0%), stinging (26.1%), burning sensation (25.4%), and itching (8.8%), while clinical signs included conjunctival hyperemia (45.5%), tear film deficiency (26.0%), and iris pigmentation changes (9.8%). Latanoprost (32.2%), timolol (23.7%), travoprost (17.6%), and brimonidine (10.2%) were the medications most frequently associated with these reactions. Optometrists primarily managed cases by switching to alternative medications (41.0%) or adjusting dosage and frequency (9.7%). However, 77.7% reported having no knowledge of existing protocols, and confidence in managing OADRs was moderately low (mean = 2.67 ± 0.49 on a 5-point scale). No significant association was found between OADR reporting and either age (p = 0.616) or years of practice (p = 0.974). These findings highlight that although OADRs are common in glaucoma management, optometrists in Ghana often lack standardized protocols and report low confidence in handling such cases. Targeted professional development and refresher training are needed to strengthen OADRs recognition, reporting, and management, ultimately improving patient eye care.