New research by Queen’s University, Wenzhou Medical University, Renmin University of China and Orbis International has found that offering glaucoma screening in China could be highly cost-effective while reducing blindness among the population.
The novel findings could change the future of glaucoma healthcare in the world’s most largely populated country.
The researchers revealed how a national screening could save government funds in the long-term as well as saving three million years of blindness among the over 50 population.
Glaucoma is the leading cause of irreversible blindness globally, affecting 64.3 million people worldwide. This disease is associated with aging, and so global numbers are rising rapidly as populations grow older. Highly effective treatments, including eye drops, laser and incisional surgery are proven to greatly reduce the risk of blindness. However, treatment must be administered early, and only around 10 per cent of those needing such treatment receive it in middle-income countries such as China.
Dr Jianjun Tang from the Centre of Public Health at Queen’s University Belfast, explains: “The research findings suggest that a national glaucoma screening programme in China could save the government money in the long-term, as it would reduce the demands on resources for the large population who would otherwise suffer completely avoidable loss of sight.”
Glaucoma is nearly always asymptomatic in its early stages, meaning that few patients present early when treatment is most effective, especially in low-resource areas, unless screening programs are carried out. But such screening has not been considered cost effective, until now, partly because of the greater expense of outreach efforts and lower risk of eventual blindness in rich countries, where nearly all previous studies have been done.
Given the disproportionate number of people affected by glaucoma in China - one third of those with glaucoma blindness worldwide - researchers at Queen’s University Belfast set out to assess the cost-effectiveness of glaucoma screening programmes there. The research, published in Lancet Global Health, provides a clear evidence that glaucoma screening in both rural and urban settings in China can save money while preventing blindness.
The study found that nearly three million years of blindness could be avoided across China’s population of 434 million people aged 50 and over through the implementation of a screening programme in both rural and urban settings. The research also highlighted the improved quality of life expected among those who received an early diagnosis.
Professor Nathan Congdon from Queen’s University Belfast and Director of Research at Orbis International, said: “This paper has the potential to be a game-changer for Orbis and our partners and beneficiaries world-wide. It fundamentally alters the way we all think about this disease, from a passive approach of waiting for patients to seek care, often too late, to actively reaching out into the community, catching glaucoma before blindness occurs.”
Dr Tang added: “Our research illustrates that a national screening programme in China is a win-win scenario for both patients and the government, and we hope that this research will inform future healthcare policies.”
This novel study, with its unexpected result, is a potential game-changer for management of glaucoma in low-resource areas globally.
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