According to the literature, the prevalence of glaucoma increases with age [2].

NB: PL− (Absence of light perception); PL+ (Presence of light perception); AV (Visual acuity); AVLsc (Distance visual acuity without correction).

Our results agree with this statement. Indeed in our series, the prevalence of 11.11% to 27.78% for the respective age groups of 31 to 40 years and 61 to 70 years. The average age of the patients was 52 years old with extremes ranging from 25 to 73 years old, which is similar to that reported by Adio and Onua [3], who had found an average age of 52.7 years. On the other hand, I. Sounouvou et al. [4], Packed [5] et al. and Kobelt et al. [6] found extreme ages higher than ours with respectively 56.3 ± 14.6 years, 62.2 years and 65 years. These observations prove that the average age of onset of POAG varies according to the studies.

The knowledge of the disease by the patient is very decisive for rapid management. In our study, 80.56% of patients did not know they had glaucoma. It would probably be linked to the asymptomatic nature and the insidious evolution of the disease where the loss of vision only occurs at the final stage. Other factors could intervene, such as the use of traditional healers and cultural beliefs. This lack of knowledge was studied in Madagascar by Bernadin et al. [7] [8] in a descriptive study on the reasons for the late detection of POAG, during which the major difficulties in the detection of glaucoma lay in the ignorance of the disease and its treatment. This finding was confirmed by MOUKOURI E. et al. [9] in Cameroon which had found that 96.72% of glaucoma patients, i.e. 59 cases out of 61, were unaware of their disease with a fortuitous discovery of glaucoma in 27.54% of patients. He attributes this to the lack of a screening strategy as well as the difficulties of access to hospital structures which mean that most patients consult at a terminal stage of the disease with a significant drop in visual acuity. [9]. In France Bron et al. estimate that approximately 400,000 French people are unaware of their disease due to the absence of suggestive functional signs before a late stage [10].

In our study, 72.22% of glaucomatous patients were not schooled. So we think aeducated patient better understands his disease and cooperates in the management of his condition. The more we know, the better we treat ourselves.

One of the factors that can influence or alter the management of the disease is the socio-economic level and affiliation to a health insurance or mutuality. In our study, the majority occupation was housewives followed by farmers and workers with 52.78% respectively; 16.67% and 13.89%. The average monthly income of 58.33% of the patients varied between (10,000 FCFA and 25,000 FCFA) and 97.22% had no health insurance or affiliated with a mutuality, which agrees with data from the Demographic and Health Survey (EDSM-2018-2019) [11] which had found national medical insurance coverage of 3%, with a disparity between rural and urban areas. Indeed, 13% of women in urban areas have taken out medical insurance against only 3% in rural areas. The same trend is observed among men (14% against 3%) [11]. This problem of subscribing to insurance is a real problem in our countries where the cost of care is borne entirely by patients and their families despite low income. This observation was made by Moukouri E. et al. [9] in Cameroon, who found that more than 60% of patients have a low socioeconomic level and are unable to fully support the costs related to the management of their disease (examinations and medication). The same observation was also made by Eballé. HAS [5], still in Cameroon, which had found a low rate of achievement of the visual field linked to the relatively high cost compared to the low socio-economic level of the patients.

I. Sounouvou [4], in Benin, found that the average monthly cost of drug treatment was (11,676 FCFA) or (?7.8) and this cost varied according to the stage of the disease. He found that a glaucomatous patient spends at the time of diagnosis on average (64874.24 FCFA) or (?8.9) in terms of direct costs (consultation, routine examinations, drugs and transport) [4]. In Nigeria, Adio and Onua [3], had found (US$105.4) expenses incurred by the glaucomatous patient.

We have not studied this aspect related to the cost of drugs, examinations and transport. But by relating the expenses of these studies to the monthly income of our glaucomatous patients and with an SMIG (Guaranteed Interprofessional Minimum Salary) in Mali at (40,000 FCFA) i.e. (?0.98) [12], we realize that they cannot face the expenses related to the care of their illness and in addition ensured their daily life. I Sounouvou in Benin had already made this observation [4].

Accessibility to eye care services in our countries poses a real problem in terms of care. Thus, 24 out of 36 patients or 66.67% were at their first ophthalmological consultation. This is consistent with the results of several African authors [13] [14] [15] [16]. This could be explained by the lack of local eye care services, certainly associated with financial inaccessibility given the low income of our populations.

The evaluation of binocular visual acuity found a frequency of blindness at 41.67% (PL− to PL+) in our patients, against 30.56% with visual acuity greater than or equal to 3/10.This frequency of blindness shows the seriousness of this sickness. Javitt JC et al. [17], found that the prevalence among black subjects was 3 to 4 times higher and had at least 4 times more blindness [15]. This blindness or low vision could have an impact on the daily life of the patient in the absence of adequate support. Thus, we found that 44.44% of our patients think they are affected by their disease. This could lead to a drop in performance or professional productivity because the majority of our patients were housewives with agriculture as their main activity; followed by farmers and workers.