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Effect of Glaucoma Awareness on Glaucoma Screening Uptake among Adults in Nigeria

Abstract

Glaucoma is a major eye-health condition and an important cause of irreversible vision loss worldwide. Because glaucoma may develop gradually without noticeable symptoms during its early stages, regular eye examinations and appropriate screening are important for early detection and timely management. Glaucoma awareness provides adults with information about the nature of glaucoma, risk factors, warning signs, consequences of delayed detection, the importance of regular eye examinations, available screening procedures, and appropriate sources of eye-care services. Glaucoma screening uptake refers to the extent to which eligible adults undergo recommended eye examinations or glaucoma screening procedures at appropriate healthcare facilities. In Nigeria, inadequate glaucoma screening uptake may be associated with limited awareness of the disease, misconceptions about glaucoma, perceived absence of symptoms, financial constraints, limited access to eye-care services, fear of diagnosis, and insufficient knowledge of the importance of routine eye examinations. Effective glaucoma awareness may improve adults' understanding of glaucoma and encourage appropriate utilization of available screening services. Against this background, this study investigates the effect of glaucoma awareness on glaucoma screening uptake among adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding adults' decisions to undergo glaucoma screening through perceived susceptibility to glaucoma, perceived severity of vision loss, perceived benefits of early detection, perceived barriers to screening, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, environmental conditions, and health-seeking behaviour in shaping screening practices. The Knowledge-Attitude-Practice framework provides a basis for examining how glaucoma awareness may improve knowledge and attitudes and influence screening uptake. Collectively, these theoretical perspectives provide a suitable framework for explaining how glaucoma awareness may influence glaucoma screening uptake among adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults in selected communities, healthcare facilities, workplaces, and other appropriate settings in Nigeria using a structured interviewer-administered questionnaire, glaucoma awareness assessment, and glaucoma screening uptake assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, households, and eligible adult participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Adults in the intervention group will receive structured glaucoma awareness education covering the meaning and types of glaucoma, risk factors, the possibility of asymptomatic disease, consequences of delayed detection, importance of routine eye examinations, available glaucoma screening procedures, recommended healthcare-seeking pathways, and locations where appropriate eye-care services can be obtained. Glaucoma screening uptake will be assessed using indicators such as previous glaucoma screening, attendance for eye examination following the intervention, completion of recommended screening procedures, and intention followed by actual utilization of available screening services. Where feasible, self-reported screening uptake will be verified using screening records or referral documentation. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, previous eye-health education, glaucoma awareness levels, history of eye examinations, and screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the effect of glaucoma awareness on glaucoma screening uptake. Where appropriate, screening uptake before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that glaucoma awareness has a significant positive effect on glaucoma screening uptake among adults in Nigeria. Adults exposed to structured glaucoma awareness education are expected to demonstrate improved understanding of glaucoma, its risk factors, the importance of early detection, and the need for regular eye examinations. Increased awareness is expected to encourage eligible adults to seek appropriate eye examinations and glaucoma screening services, particularly among individuals with recognized risk factors. Education may also reduce misconceptions that glaucoma screening is necessary only when visual symptoms occur and may increase awareness of the potential benefits of detecting the disease before significant vision loss occurs. However, awareness alone may not guarantee screening uptake because adults may continue to experience barriers such as cost of eye-care services, limited availability of eye-care professionals, geographical distance from screening centres, transportation difficulties, fear of diagnosis, and competing health priorities. Consequently, glaucoma awareness may be most effective when supported by accessible and affordable eye-care services, community-based screening programmes, effective referral systems, and sustained public eye-health campaigns. The study is expected to contribute to the literature on glaucoma awareness, eye-health education, glaucoma screening, preventive healthcare, health-seeking behaviour, health promotion, and public health in Nigeria by providing empirical evidence on the effect of glaucoma awareness on screening uptake among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, ophthalmology and optometry services, hospitals, primary healthcare centres, eye-care organizations, public health practitioners, health educators, community health workers, development partners, and policymakers regarding strategies for improving early detection of glaucoma. The study will also provide evidence-based recommendations for strengthening community glaucoma-awareness programmes, integrating eye-health education into primary healthcare services, expanding accessible screening opportunities, improving referral systems, reducing financial and geographical barriers to eye care, and promoting regular glaucoma screening among adults in Nigeria.

Keywords: Glaucoma awareness, glaucoma screening uptake, adults, Nigeria, eye health, glaucoma screening, eye-health education, preventive healthcare, health-seeking behaviour, vision loss prevention, ophthalmic health, health promotion, public health.