Management of Glaucoma in Resource-Limited Settings: Experiences from Kebbi State Eye Care Programme

Effective glaucoma management in resource-limited environments requires creative adaptation of clinical protocols, task-sharing models, and patient engagement strategies. This study examines the management approaches employed in the Kebbi State Eye Care Programme, with specific focus on glaucoma patient care at district-level health facilities in North West Nigeria. A mixed-methods study design will be employed, combining retrospective review of glaucoma case records from 2020 to 2023 with semi-structured interviews of ophthalmologists, ophthalmic nurses, and programme coordinators. Quantitative data will cover intraocular pressure at diagnosis, medications prescribed, surgical referrals made, treatment adherence rates, and visual field outcomes. Qualitative data will explore perceived barriers and facilitators to sustained glaucoma management in the programme. Both datasets will be analysed separately before integration. The Kebbi State context is characterised by a sparse ophthalmologist workforce, limited access to advanced diagnostics, and high patient transport costs, all of which intersect to create suboptimal glaucoma outcomes. This study provides a programme-level evaluation that generates actionable insights for the Kebbi State Ministry of Health and international partners seeking to strengthen glaucoma services in comparable settings. Recommendations will address medication availability through essential medicines listing, task delegation to ophthalmic nurses for routine monitoring, and telemedicine integration to reduce unnecessary specialist visits. Documenting effective resource-limited glaucoma management models is vital for scaling evidence-based approaches across northern Nigeria. Keywords: glaucoma management, resource-limited setting, Kebbi State, task-sharing, ophthalmic nursing