Challenges and barriers to early detection of primary open-angle glaucoma at the primary health care level: A scoping review.

Introduction Primary open-angle glaucoma (POAG) is the most common type of glaucoma, accounting for over 86% of cases globally. As a major cause of irreversible blindness, early diagnosis and treatment are crucial to prevent disease progression. However, POAG is often diagnosed at advanced stages, due to insufficient and inconsistent screening in primary healthcare settings, negatively influencing prognosis and complicating treatment and management. Methods The development and conduct of this scoping review were guided by the 2020 Joanna Briggs Institute (JBI) guidelines for conducting scoping reviews, following the framework established by Arksey and O’Malley. In alignment with the published protocol, systematic searches were conducted across several databases, including PubMed, EMBASE, Scopus, and the Web of Science and MEDLINE platforms. These searches focused on peer-reviewed articles published in English from January 2000 to March 2025. Resources were included if they reported on individuals who had been screened and diagnosed with primary open-angle glaucoma (POAG) for the first time. Results A total of twenty-one resources were included in this review, with eight sourced from SSA (Sub-Saharan Africa). Of these studies, four focused specifically on screening for primary open-angle glaucoma (POAG), while the remaining studies concentrated on its diagnosis. Most of the research was conducted at the secondary healthcare level (n=12), and in the majority of these studies, screening was performed by eye specialists. The most commonly used equipment included visual acuity charts, tonometers, slit lamps, ophthalmoscopes, and Humphrey field analysers. Conclusion There is a significant need for screening of POAG at the primary health care level, especially in sub-Saharan Africa. This will improve early detection of POAG, and subsequently reduce the prevalence of avoidable blindness.