Glaucoma Knowledge, Self-Reported Risk Factors, and Eye-Care Access in Selected Rural and Urban Communities of Abia State, Nigeria

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Abstract Background: Glaucoma is a progressive optic neuropathy and is the leading cause of irreversible blindness globally. Blindness can be prevented by public awareness of glaucoma, identification of risk factors, and eye-care habits. This study aimed to compare the knowledge, self-reported risk factors, and access to eye care services between selected rural and urban communities of Abia State, Nigeria. Methods: A community-based comparative cross-sectional study was conducted among 468 adults aged ≥40 years (234 rural, 234 urban). Participants were selected using a multistage sampling method and completed a pre-tested interviewer-administered questionnaire. Ten items assessed glaucoma knowledge; a score ≥5 was classified as good knowledge. Data were analyzed using descriptive statistics and chi-square tests, with statistical significance set at p<0.05. Results: Rural residents had significantly lower glaucoma awareness (35.9% vs 69.7%; p<0.001) and good knowledge (33.3% vs 68.4%; p<0.001) compared with urban residents. Compared to urban respondents, rural respondents were less likely to be aware of key prevention messages, such as glaucoma has no early symptoms (32.1% vs 85.5%), glaucoma runs in families (21.4% vs 59.8%), and blindness is preventable (29.9% vs 76.9%). There were no significant differences in self-reported risk factors by setting. Access to eye care was markedly lower in rural areas (34.2% vs 74.4%; p<0.001). Of those who could get access, 65.0% of rural people only had eye checks when they had symptoms, compared to 50.0% of urban people who had annual eye checks. Cost was the main barrier in both groups, followed by distance and lack of symptoms. The pattern of barriers did not differ significantly between communities (χ² = 0.50, p = 0.781). Conclusions: Significant rural-urban disparities exist in glaucoma knowledge and preventive eye-care practices in Abia State. Targeted health education and community-based screening programmes, particularly in rural areas, are urgently needed to reduce avoidable blindness from glaucoma.

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