INTRODUCTION

Glaucoma is the second cause of all blindness in the worldwide and affects more than 50
million people. World Health Organization (WHO) estimated approximately 40-45 million
people worldwide are blind, one of third were in Southeast Asia. It Means every minute
estimated 12 people became blind, four of whom also came from Southeast Asia (MOH,
2007). In children, there is one child every minute of being blind and almost half are in South
East Asia. Whereas in young children, the WHO estimates that there are 1.4 million are
suffering from blindness with three quarters of them in poor areas in Asia and Africa.

Blindness problem in Indonesia is more a social issue than a problem of health. This is in
according with the WHO criteria, that is when the number of blindness more than 1%, so
including the social problems, not only a matter of blindness.

Based on the survey results of the WHO, in 2002 the leading cause of blindness are cataract
(47.8%), glaucoma (12.3%), uveitis (10.2%), age related macular degeneration (AMD)
(8.7%), trachoma (3.6%), corneal opacity (5.1%) and diabetic retinopathy (4.8%) 3.

Based on Survey of sense Vision Health in 1993-1996, which is done by the Health Ministry
of the Indonesia Republic found that glaucoma is the number 2 that cause blindness after
cataract. 1.5% of Indonesia's population with the main causes of blindness are cataract
(0.78%), glaucoma (0.20%), refractive errors (0.14%), retina (0.13%), corneal abnormalities
(0 , 10%) 4. National prevalence of glaucoma 0.5% (based on the complaint of respondents).

In the West African sub-Sahara countries, glaucoma is the second leading cause of blindness
after cataract5 . In America, glaucoma is one of cause legal blindness with an estimated 12%
of new cases in a year, the Blacks and Hispanic glaucoma is the second leading cause of
blindness after cataract6. Whereas in European countries, glaucoma included in the top five
blindness disease groups.

The Prevalence estimates based on the latest population study in the United States (U.S.),
Australia and Europe based on U.S. census in 2000, an estimated 937 000 (0.78%) of
Americans over the age of 40 years suffer blindness. As an additional 2.4 million of
Americans (1.98%) had low vision. The main cause of blindness in people of white skin that
is Age-Related Macular Degeneration (54.4% of cases), among blacks cataract and glaucoma
were more than 60% of blindness.
According to Bambang and his colleagues are conducting research in Lamongan East Java, it
acquired that blindness caused by glaucoma in both eyes 0.20% and 0.14% in one eye.

North Sumatra province consists of 13 districts and 6 cities with the population number of
11,476,272 inhabitants, has 46 hospitals and 402 Community Health Centres. Herman
research resulted on the prevalence of blindness due to glaucoma in South Tapanuli 0.068%
in 2009, research Reni Guspita about blindness due to glaucoma prevalence in Langkat of
0.037%, and the study by Nilawati Enny 0.031% (bilateral blindness) and 0.015% (unilateral
blindness) years 20088,9,10. This prompted the authors to study the prevalence of blindness
due to glaucoma, especially in Haji Adam Malik Hospital in Medan in 2011.

RESEARCH OBJECTIVES

To Get the numbers of blindness from glaucoma in Haji Adam Malik Hospital in Medan in
2011 and the factors that influenced the rate of blindness due to glaucoma.

Classification ICD 10 to low vision

Tabel

RESEARCH METHODOLOGY

This study is a retrospective descriptive study, with take sample data from medical record of
patients who came for treatment to the Ophthalmology ployclinic Haji Adam Malik Hospital
in Medan during the period of January to December 2011.

INCLUSIONS CRITERIA

All glaucoma patients who visited Ophthalmology ployclinics Haji Adam Malik Hospital in
Medan period January to December 2011 with the best visual acuity in one eye or both eyes ≤
3/60.

Exclusion criteria
Medical records are not complete
The road RESEARCH AND HOW WE WORK

Collection of data that retrieved from medical records of patients who visited the Haji Adam
Malik Hospital in Medan from January to December 2011 with the diagnosis of glaucoma.
From the medical records of patients were selected who fulfill the inclusion criteria with
visual acuity ≤ 3/60 in one eye and two eye after the best correction. All patient data is
recorded, after the data is collected is processed in the form of a table.

RESULTS
The number of patients who come to Haji Adam Malik Hospital in Medan were noted from
the medical records in the period January - December 2011 totaled 7456 patients. From the
number of these patients found patients with blindness caused by glaucoma in one eye
(unilateral) 45 people (54.88%) and in two eyes (bilateral) 37 people (42.12%).
AGE
Distribution of blindness caused by glaucoma based on age.

Tabel

From the table above the age of majority percentage of blindness caused by glaucoma in one
eye (unilateral) in age group 61-80 years 22 (48.9%). And in both eyes (bilateral) at the age
of 41-60 years 14 (37.84%)

SEX
Distribution of blindness caused by glaucoma based on sex

Tabel

From the table above showed the percentage of occupation people with blindness caused by
glaucoma in one eye (unilateral) was a housewife most 10 people (22.22%), and in both eyes
(bilateral) also most in housewife 10 people (27 , 02%).

Family history
Distribution of blindness caused by glaucoma based on family history

tabel

From the table above showed the percentage of patients with a family history of blindness
due to Glau-coma pd one eye (unilateral) mostly in patients who have a family history does
not clear 22 people (48.89%), and in both eyes (bilateral) is also the largest in the history of
the family it is not clear that 20 people (54.05%).

History of systemic disease

Distribution of blindness caused by glaucoma by history of systemic disease

Tabel’

From the table above shows the percentage of patients with a systemic disease history of
blindness caused by glaucoma in one eye (unilateral) in most samples that had a history of
hypertension as many as 23 people (51.11%), and in both eyes (bilateral) found the highest
percentage in the history of hypertension 14 people (37.84%).

A history of drug use

Distribution of blindness due to glaucoma based on drug use history.

Tabel

From the table above showed the percentage of patients with a drug use history in blindness
patients due to glaucoma in one eye (unilateral) mostly in patients who do not drop out of
medicine as many as 31 people (68.89%), and in bilateral (both eyes) also had the highest
percentage also in patients with no history of drug withdrawal is 21 people (56.75%).

History of using eye glasses

Distribution of blindness caused by glaucoma based on history of using eye glasses

Tabel

From the table above, the percentage of patients with a history of using eye glasses in
blindness patients caused by glaucoma in one eye (unilateral) mostly in patients with myopia
glasses users 33 people (73.33%), and both eyes (bilateral) in highest percentage of people
with myopia glasses have 26 users people (70.27%)

Classification of glaucoma type

Distribution of blindness caused by glaucoma based on classification of glaucoma type

Tabel
From the table above, the percentage of glaucoma type classification in blindness patients
caused by glaucoma in one eye (unilateral) mostly in patients with open-angle 25 people
(55.55%), whereas in both eyes (bilateral) at most close-angle 23 people (62.16% ).

DISCUSSION
The highest percentage of patients with glaucoma in a 61-80 years age group 48.9%. This is
according with the existing literature and research is ever done, it said that age as a risk factor
for blindness caused by glaucoma is over 40 years and the risks grow as same as its
increasing age.

The highest percentage of patients based on gender were women 55.56%. From the existing
literature did not mention the influence of gender on glaucoma, only in the acute close angle
glaucoma, it said women more often than men. Several studies in normal eye indicated that
the chamber of anterior was more shallow in women than in men, it is this which makes the
risk of close angle glaucoma is increased in women.

The highest percentage rate in patients with glaucoma was Batak ethnic 31.11%. This is
possible becaused a lot of the Batak ethnic come to RSUP.H.Adam Malik to get treatment.

The highest Percentage of glaucoma patients based on occupation who are female is 22.22%
housewives.
The percentage of glaucoma patients basedon family history is not clear at 48.89%. This is
consistent with the existing literature as well as teams of research has ever done, it said that a
family history of glaucoma as a risk factor for blindness dueto glaukoma.

The Highest percentage of systemic disease history in patients with a history of hypertension
51.11%. This is consistent with the existing literature and studies that have been conducted,it
said that the history of comorbid disease as a risk factor for blindness caused by glaucoma.
The Percentage of drug use history was higher in patients who did not drop out of medicine
68.89%. This suggested that the response of patients and health care of itself particularly
about eye health.
The Percentage of glass-eye use history in patients with myopia 73.33%. This is
consistent with the existing literature and research is ever done, it mentioned that myopia as
a risk factor for blindness caused by glaucoma
The Percentage of glaucoma classification in one eye (unilateral) more on open-angle
55.55%, whereas bilateral blindness in a closed angel 62.16%. Unilateral secondary
glaucoma often occured, and many secondary glaucoma have a closed angle types. Primary
open-angle glaucoma also did not rule out the development of the disease within its
interchangeable become angle glaucoma tertutup9 ,11 to 15.
 From the total sample of 82 people, it encountered blindness of one eye (unilateral) 45
men and in two eyes (bilateral) 37. Number one or two eye blindness obtained with the
formula number of people divided by the number of samples multiplied by 100%, in the rate
of blindness can be one eye (unilateral) 54.88%, the rate of blindness both eyes (bilateral)
42.12%.

The prevalence of blindness due to glaucoma in Haji Adam Malik Hospital in Medan in 2011
with a number of blindness caused by glaucoma formula divided the total number of patients
in the Ophthalmology clinics of Haji Adam Malik Hospital in Medan in 2011 multiplied by
100%, it get the prevalence 1.10%. The prevalence of blindness due to glaucoma in one eye
(unilateral) 0.60%. The prevalence of blindness due to glaucoma in both eyes (bilateral)
0.50%.

CONCLUSION
The prevalence of blindness due to glaucoma at the General Hospital Malik H.Adam
1.10%, unilateral blindness 0.60% and bilateral blindness 0.50%.

ADVICE
Counseling should be given to the community for eye examinations for early detection of
glaucoma.