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Glaucoma: an exclusive disease?
  1. T Shaarawy
  1. T Shaarawy, Glaucoma Sector, Ophthalmology Service, Department of Clinical Neurosciences, University of Geneva, 22 rue Alcide Jentzer, 1211 Geneva, Switzerland; tarek.shaarawy{at}

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The first suggestion of a disease associated with a rise in intraocular pressure (IOP) and thus corresponding to what is now known as glaucoma seems to occur in the Arabic writings of Shamms Ad-Deen of Cairo (died ad 1348) who, among 153 diseases of the eye and adnexa, described a “migraine of the eye” or “headache of the pupil,” an illness associated with pain in the eye, hemicrania, and followed by dilatation of the pupil and cataract. If it became chronic, tenseness of the eye and blindness supervened.1

Eldaly and co-authors, from Cairo University in Cairo, Egypt, the same city of Shamms Ad-Deen, produced an interesting article on the socio-economic impact among Egyptian glaucoma patients.2 Egypt, with a population close to 75 million, of whom 20% fall below the poverty line, serves as an excellent model of how glaucoma is managed in a developing country. Having said so, it is of fundamental importance to discourage the grouping of all developing countries in one basket, as circumstances vary significantly between them. This includes the number of physicians per capita, gross domestic product (GDP), and total expenditure on health as percentage of GDP, among others.

Egypt has a ratio of 2.1 physicians per 1000 people, a ratio identical to that of the UK, New Zealand and Canada.3 The same ratio contrasts dramatically with ratios in Zimbabwe (0.05) and Rwanda (0.01). Egypt invests 6% of its GDP on health services, amounting to $258 per capita, which again can be compared with the UK (8%, $2560 per capita) and Rwanda (3.7%, $14 per capita).4 The statistics cannot …

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  • Competing interests: None.