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An Island-Wide Survey

Steve K. L. Seah, FRCSG, MMed; Paul J. Foster, FRCSEd; Paul T. K. Chew, FRCSEd, MMed; Aliza Jap, FRCSG; Francis Oen, FRCSEd, MMed; Han Bor Fam, FRCSEd; Arthur S. M. Lim, FRCS

Arch Ophthalmol. 1997;115(11):1436-1440.

Abstract
Objectives
To determine the incidence of acute primary angle-closure glaucoma (APACG) in Singapore and to identify demographic and meteorological risk factors.

Design
A prospective, island-wide incidence study.

Setting
All government and private ophthalmological practices in Singapore, from March 1, 1995, to February 29, 1996.

Methods
New cases of APACG were identified by all ophthalmologists in Singapore during a 1-year period. Demographic and clinical details were recorded.

Results
One hundred eighty-nine people (208 eyes) were seen with APACG for the first time during the 1-year period. These new cases represent an incidence of 12.2 per 100 000 per year (95% confidence interval, 10.5-13.9) in those aged 30 years and older. Major risk factors identified were female sex (relative risk, 2.4), Chinese ethnic origin (relative risk, 2.8), and age of 60 years or older (relative risk, 9.1). Half of those affected were seen 3 days or more after the onset of symptoms. Attacks were more frequent on hotter days. There also was a relationship between the number of attacks per day and the mean number of sunspots and mean solar radio flux during the previous 30 days.

Conclusions
There is a high incidence of APACG in Singapore, with elderly women being the highest risk group. Chinese Singaporeans are at higher risk than other ethnic groups (Malay and Indian). There is often a substantial delay before these patients consult a physician. The onset of APACG seems to be associated with meteorological factors.

Author Affiliations
From The Singapore National Eye Centre (Drs Seah, Foster, Jap, and Oen and Mr Lim), National University Hospital (Dr Chew and Mr Lim) and Tan Tock Seng Hospital (Dr Fam), Republic of Singapore.; Dr Foster is a research fellow from The Institute of Ophthalmology and the Glaucoma Unit, Moorfields Eye Hospital, London, England.

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