Impact of Glaucoma Disease .docx

Impact of Glaucoma Disease
1
Impacts of Glaucoma Disease on African Americans
Lendora Ogunbode
PSY 625
Dr. N
July 27, 2019
Impacts of Glaucoma Disease on African Americans
Specific Aims
Neuroscience refers to a medical field which is widely covered
in medicine. It generally
involves the study of the human brain and its association with
the entire human body’s nervous
system coordination. Therefore, all the human senses are
studied under this neuroscience field of
medicine. Specifically, for this assignment, blindness as a
branch of neuroscience will be dealt
with. The sense of seeing is usually aided by the relay of visual
information within the human

brain. Several diseases which are related to human nervous
system like Glaucoma have been
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Impacts of Glaucoma Disease
analyzed both neurologically and technologically. Although it is
generally a complex process as
far as medical is concern to bringing a remedy or cure to a
disease which is associated with the
human nervous system more especially when some specific
tasked relays and neurons within the
system have been damaged, especially during accidents,
technology is recently playing a great
advancement towards finding the possible ways at achieving an
effective treatment to
neuroscience related cases (Charlson et al. 2015).
Glaucoma disease has been given priority in this research since
it’s the most common
blindness condition which has threatened the entire world.
"Glaucoma occurs about five times
more often in African Americans. Blindness from glaucoma is

about six times more common. In
addition to this higher frequency, glaucoma often occurs earlier
in life in African Americans —
on average, about ten years earlier than in other ethnic
populations" ("African Americans and
Glaucoma," n.d.). Many research results have indicated the
technology in collaboration with
neuroscience have taken a significant step in coming out with
innovative measures which are
aimed at understanding the causes, the impacts as well as the
remedy actions of blindness. These
efforts of neuroscience and medical technology will be
evaluated in this study as well.
The specific aim of this proposal is to access three main
aspects that are related to
Glaucoma, first is the examination of ethnic variations which
are closely related to Glaucoma
disease, the second examination will be on the potential causes
of Glaucoma, and finally
monitoring the impacts of cognitive progress of patients that are
clinically diagnosed with
Glaucoma disease (Freedman, Shen, & Ahrens, 2016).
Background of the Study

Cases of glaucoma have been reported all over the world.
The number of people affected
by glaucoma to an extend of becoming blind has increased
significantly in recent years. This
PSY625: Biological Bases of Behavior Ashford University
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1
2
1. n.d.).
Correct citation format and
give page number for direct
quote. [Irene Nielsen]
2. the
You can discuss all three but
for a manageable research
proposal pick one to focus on
and develop deeply. [Irene
Nielsen]

3
increase in severe cases of glaucoma has led to more research
being conducted to discover ways
of dealing with the problem. Over the years, neuroscience
experts have been able to advance in
medical procedures to limit the prevalence of glaucoma.
Various medications have been
developed by neurologists to solve the issue of glaucoma.
However, the medications and
prevention measures have not been beneficial to everyone.
Some ethic groups have positively
benefited from the discoveries made through research while
others have experienced no
meaningful impact. To be more specific, people of black color
pigmentation are still widely
affected by glaucoma. The rate of glaucoma among black
people, especially African Americans,
is very much greater compared to incidence rate in white people
populations, (Hoster, 2011).
Despite the clear identification of a relationship between
glaucoma incidence and
black pigmentation, very little research has been conducted.
This study aims at analyzing the

relationship that does exist between glaucoma and black
pigmentation. Also, the study will focus
on establishing how the relationship could be altered so as to
facilitate and enhance treatment of
glaucoma in people of African origin. A lot of insight and
relevant knowledge has been offered
through various neuroscience research that have been
conducted. The information available form
previously conducted research indicates that a relationship
exists between the cranial nerves
within the human nervous system and glaucoma. This research
intends to advance the knowledge
available about the relationship stated above.
People of African origin have for long been affected by partial
or complete
blindness due to glaucoma. The disorder affects African people
of all ages and becomes more
severe in adults. The probability of any African person
becoming blind as a result of glaucoma is
very high compared to the probability of blindness for other
ethnic groups affected by glaucoma.
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1
1. blindness
Is this true in al environments
or more preveland where
there is more sunlight?
[Irene Nielsen]
4
Different researchers in the neurosciences profession have
attempted to come up with theories
that explain the high rate of glaucoma level in people of African
heritage, (Iwase, et.al., 2014).
Some of the researchers have focused on identifying viable
ways of reducing the
rate of blindness among African people affected by glaucoma.
The extensive research conducted
in this area has led to development of special drops which are
used to relieve pressure from the
eye and thus reduce the likelihood of blindness caused by
glaucoma, especially among people of
African heritage, (Jawitt, et.al., 1991). The availability of such

data and information serves as a
good basis upon which this study would be referenced to.
The study will focus on advancing the available information to
facilitate a better
understanding of the relationship between glaucoma and
blindness amongst the African
American population. A study conducted by NIH analyzed the
effectiveness of eye drops in
reducing pressure in the eye amongst African American
populace. A large study group of African
American men was used in the research which later came to be
known as Ocular Hypertension
Treatment Study (OHTS). The aim of the study was to identify
the usefulness and advantage of
using eye drops as a treatment measure to reduce the probability
of blindness. The research
findings supported the theories that had already been developed
in previous research.
In another research, Obrien, et.al., (2018) found that
open angle glaucoma in people of
African origin was much more expected where the family had a
history of glaucoma. The
research conducted indicates that glaucoma may be inherited
form one generation in a family to

another. The research suggests that family background is among
the factors causing more
glaucoma incidence in African Americans that in other ethnic
groups. The study indicates that
genetics and other factors such as ocular comorbidities, which
are in some cases hereditary are
the main causal factors of glaucoma in people of African
heritage.
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1
2
1. especially
This source is outdated but
find a current source with
similar conclusions. [Irene
Nielsen]
2. African
Is this conclusion supported
by the genome study through

23 and me? I think there is a
descrepiancy of conclusions.
[Irene Nielsen]
5
Retrepo, et.al., (2018), conducted an extensive research to
identify the
relationship between glaucoma and genetics among people of
African origin. The research
focused on analyzing the genetic ancestry of various persons
within the study group. The
research indicates that open angle glaucoma is the most
common type of visual disorder among
people of African heritage. On further research and analysis, the
study identifies that the
environmental factors are the main causal factors of open angle
glaucoma among African people.
Exposure to extreme environmental conditions is noted as the
contributing factor to glaucoma
incidence.
Yuecel & Gupta, 2008. Conducted a research on the relationship

between central
nervous system and glaucoma in African Americans. The
research findings indicated that
retrograde degeneration as well as anterograde degeneration of
the optic nerve occurred in the
recovery process after the central nervous system had
experienced an injury. The degeneration
of the optic nerve was also noted to have a certain level of
impact on the cognitive ability of the
affected person. The resulting effect of the degenerative optic
nerve is a condition of partial
blindness which develops into complete blindness with time.
Different research studies conducted by neuroscientists have
analyzed various variables
in the quest to prove and give factual information about the high
incidence of glaucoma among
African American people. Some of the theories have been
developed to explain the difference in
oxygen levels supplied to the eye, indicating that African
people supply more oxygen to the eye
more than any other ethnic group. The ultimate outcome of
excess oxygen supply to the eye is
increased intraocular pressure. This would happen due to too
much oxidative pressure on the eye

membranes leading to damages eye cells. Damages cells would
not be able to hold and protect
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1
2
1. open
Explain open angle and relate
it to neurology. [Irene
Nielsen]
2. injury.
what kind of injury? A broken
toe? [Irene Nielsen]
6
the eye from excess pressure thus resulting to a condition of
partial blindness. The conditions
further manifests to glaucoma and ends up causing blindness,
(Yuecel & Gupta, 2008).

Lawlor, et.al., (2018) conducted a study to establish the
relationship between
glaucoma and blindness among people of African origin. The
study established that glaucoma is
a condition caused by degeneration of the optic nerves in the
eye. The research was done through
analysis of different patients who suffered from glaucoma. The
findings indicated that there were
variations in the optic nerves of the patients due to trans-
synaptic degeneration of optic nerves in
the eye, (Lawlor, et.al., 2018).
In another research, Racette, et.al., (2015), examined a study
group of 50 white
men and 50 black men. The study intended to establish the type
of variations that exist in optic
nerves of white people and black people. The sizes of the optic
nerves varied in size. This finding
is supported by Seider et.al., (2019) through a study that took
over 3 years to be concluded.
Seider et.al., (2019), found that black people often have thick
optic nerves compared to white
people therefore increasing the rate of glaucoma in black
people.

Significance
The proposed research is expected to benefit the persons
affected by glaucoma in society.
It has been reported through various studies that African
Americans are the mostly affected by
glaucoma. It is also noted that the same group of people are the
most common to experience
open angle glaucoma which often results to blindness,
(Charlson, at al. (2015). The proposed
research aims at shedding new light on the issue and further
defining the existing relationship
between blindness caused by glaucoma and pigmentation of
various ethnic groups.
The first step of gaining power over glaucoma related blindness
is through
advancement of existing knowledge on the issue. Therefore, the
proposed research will offer
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1
2
3

1. nerves
Get this organized with
previous statements. [Irene
Nielsen]
2. degeneration
What is the cause? [Irene
Nielsen]
3. increasing
Why does an increased sized
nerve increase the disease?
Explain. [Irene Nielsen]
7
relevant information to enhance the understanding of how
different ethnic groups are pre-
exposed to glaucoma. The research proposed will also add on
the existing knowledge. Through
review done on existing material, both theoretical and
empirical, the research will identify links

that may be yet to be discovered in the field of neuroscience,
(Williams et.al., 2018).
The research would also facilitate the filling of knowledge gaps
that exist in the
already published research work. The research will attempt to
answer questions that have
remained unanswered about the relationship between glaucoma
related blindness and ethnicity as
well as how glaucoma affects cognitive ability. Also, the
research will provide information about
how glaucoma in African Americans may be caused by some
hereditary factors such as genes,
(Salowe, 2017). Availability of the information will be crucial
to set stage for a discussion on
how to prevent the disorder and not just providing treatment to
the affected persons, (Pressman,
2018). The research will also design a database where all
findings will be recorded to facilitate
future reference.
Proposed Research
Participants:
This proposed research will involve a sample study group
of 80 individuals. This

group number will be subdivided into various sample sizes of
equal number of individuals
depending on the geographical location of the sample as well as
the ethnic groups. The ethnic
groups that will be considered in this study sample include
African American, Asian American,
Native American, Hispanic American as well as Native
Africans. The study duration will range
from two months to five months, with two months being the
minimum and five months being the
maximum. The study sample will comprise various categories of
individuals which include age,
youth, and adults as well as gender sensitive (Pressman, 2018).
The individuals who will be
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1
1. 80
This is too large for a small
study with only $60,000.
[Irene Nielsen]

8
taking part in the study will be expected to be available
throughout the entire study period. On
the side of professionals, there will be two certified
ophthalmologists, one clinician who will be
well informed on research topic. These professionals are
inclusive just to ensure that everything
goes on successfully.
Procedures:
Once the sample has been identified, they will be visited in
their homes by the
professionals with our assistance. They will be given the
necessary training concerning what they
will be expected of throughout the entire study period. The
assessment of their eyesight will be
evaluated once every month and the results analyzed (Restrepo,
Laper, Farber-Eger, & Crawford,
2018).
Research Methodology and Design
This research will employ the research methods that will satisfy
the objectives of the study.

Besides making use of quantitative stats, this section will deal
with the design, population, and
collection of data and how it will be analyzed.
Research Design
This is the research planning framework besides the
methodology to be applied in the
study, assumptions as well as models. In this research,
quantitative stats will be employed as well
as positivist ontological paradigm. This model describes besides
explaining the real
characteristics by collecting data on observable behavior of a
sample. The research problem will
be studied by using descriptive research design.
Population of the Study
This study will consider a population sample of 80 individuals
who will be subdivided
into sub-samples within the United States which will constitute
the requisite population. Castillo
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1
2

3
4
1. successfully.
Will they give clinical care if a
subjects claims harm or
damage? [Irene Nielsen]
2. training
Outline the specific training
program. [Irene Nielsen]
3. will
What is your research
question? What is your
hypothesis, variables, study
design, risks, and
methodology? Use the
alternative template I required
in the announcement at the
beginning of class, including

research terminology. [Irene
Nielsen]
4. sample
Organize this with previous
statements. [Irene Nielsen]
9
(2018), defined a population as clearly defined objects
possessing similar attributes with
observable traits upon which an opinion will be based.
Data Collection
The data will be generally collected by making use of primary
data collection method.
This will be achieved via questionnaires as a tool for data
collection from the identified
population who will be the respondent. The Questionnaire will
consist of a series of verbal or
written questions followed by medical examination.
Data Analysis and Hypothesis

Data analysis will entail summarily organizing data by making
use of mathematical tools
with a view of establishing the existing relationship within the
collected data. According to
(Williams et al. 2018), data analysis refers to a method of
extracting useful and relevant
information from collected data so as to facilitate brief
description of research work. In this
research, both regression analysis as well as quantitative stats
will be applied. In establishing the
relationship between glaucoma and black pigmented
individuals, the following logical regression
expression will be applied, G = f(x1, x2, x3, x4); more
specifically, the regression quantitative
equation will be as follows; Y = α0 +α1x1+ α2x2+ α3x3+ α4x4
in this case, Y is the dependent
variable which demoted glaucoma and X represents the
independent variable which denoted
color pigmentation. α0 is a constant with x1, x2, x3 and x4
being the color pigmentation variables
(Williams et al. 2018).
Budget Justification
It’s obvious that for a graduate research assistant, funding is
necessary for the purpose of

effectively carrying out training, recruitment of the five
required professionals as well as
collecting data. Another extra 25% funding will be required for
the payment of principle
- 9 -
1
1. entail
What is your research
question? What is your
hypothesis? [Irene Nielsen]
10
investigator who will be overseeing that the study is smoothly
carried out, and to ensure that the
data collected is accurately analyzed besides the results
publication.
Travelling funding will be also asked for; this will cater for PI
attendance to medical
conferences besides presenting the preliminary findings of the

research. Extra funding will be
required to cater for the transportation expenses by the graduate
research assistant who will be
moving from one home to another to collect data from the
proposed sample size. Subject
imbursement of $45 for every subject (35 in total) is requested
to repay subjects for their
participation time.
Funding will also be required in hiring the clinical equipment’s
to be used in population
assessment plus funding to cater for life scale quality as well as
office stationeries and supplies.
Finally, in the collection and analysis of data, technology will
be required for speed and
efficiency; therefore, two laptops will be required of processor
speed of 2.4GHz and storage
capacity of 500 MB each.
See Appendix A: Budget for detailed budget figures.
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1
1. imbursement

spelling [Irene Nielsen]
11
References:
Charlson, E. at al. (2015). The Primary Open-Angle African-
American Glaucoma Genetics
(POAAGG) Study: Baseline Demographics. Ophthalmology.
122(4).
Freedman, J., Shen, E., & Ahrens, M. (2016). Trabeculectomy is
a Black American glaucoma
population. British Journal of Ophthalmology, 60(8), 573-574.
Girkin, C. A. (2018). Differences in optic nerve structure
between individuals of predominantly
African and European ancestry: Implications for disease
detection and
pathogenesis. Clinical Ophthalmology (Auckland, NZ), 2(1), 65.
Jawitt, J.C., et al. (1991). Undertreatment of glaucoma among
black Americans. New England
Journal of Medicine .325(20).
Lawlor, M., Danesh-Meyer, H., Levin, L. A., Davagnanam, I.,
De Vita, E., & Plant, G. T. (2018).

Glaucoma and the brain: trans-synaptic degeneration, structural
change, and implications
for neuroprotection. Survey of Ophthalmology, 63(3), 296-306.
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1
1. (1991).
The source you have used is
outdated. Be sure to focus
your research on things that
have been published within
the last five to ten years,
unless referring to seminal
works or thinkers. [Irene
Nielsen]
12
O'Brien, J. M., Salowe, R. J., Fertig, R., Salinas, J., Pistilli, M.,

Sankar, P. S., ... & Gordon, K.
(2018). Family history in the primary open-angle African
American glaucoma genetics
study cohort. American journal of ophthalmology, 192, 239-
247.
Omoti, A., & Akpe, B. A. (2009). Race and Primary Glaucoma.
Current Medical Literature:
Ophthalmology, 19(1), 1–7. Retrieved from
http://search.ebscohost.com.proxy-
library.ashford.edu/login.aspx?direct=true&db=a9h&AN=36660
950&site=eds-
live&scope=site
Pressman, P. (2018). The Cranial Nerves and Their Functions.
Very Well Health. Retrieved
from https://www.verywellhealth.com/the-cranial-nerves-
2488654
Restrepo, N. A., Laper, S. M., Farber-Eger, E., & Crawford, D.
C. (2018). Local genetic ancestry
in CDKN2B-AS1 is associated with primary open-angle
glaucoma in an African
American cohort extracted from de-identified electronic health
records. BMC medical
genomics, 11(3), 70.

Salowe, R., O’Keefe, L., Merriam, S., Lee, R., Khachatryan, N.,
Sankar, P., … O’Brien, J.
(2017). Cost and yield considerations when expanding
recruitment for genetic studies: the
primary open-angle African American glaucoma genetics study.
BMC Medical Research
Methodology, 17, 1. Retrieved from
http://search.ebscohost.com.proxy-
library.ashford.edu/login.aspx?direct=true&db=edb&AN=12414
9300&site=eds-
live&scope=site
Swierkowska, J., & Gajecka, M. (2017). Genetic factors
influencing the reduction of central
corneal thickness in disorders affecting the eye. Ophthalmic
Genetics, 38(6), 501–510.
https://doi-org.proxy-
library.ashford.edu/10.1080/13816810.2017.1313993
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13

Williams, A. M., Huang, W., Muir, K. W., Stinnett, S. S., Stone,
J. S., & Rosdahl, J. A. (2018).
Identifying risk factors for blindness from primary open-angle
glaucoma by race: a case-
control study. Clinical ophthalmology (Auckland, NZ), 12, 377.
Yuecel, Y., & Gupta, N. (2008). Glaucoma of the brain: a
disease model for the study of
transsynaptic neural degeneration. Progress in brain research,
173, 465-478.
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1
1. Glaucoma
Outdated. Find a
complimentary article that is
current. [Irene Nielsen]
14

Appendix A
Budget
SUMMARY PROPOSAL BUDGET FOR INSTITUTION USE
ONLY
ORGANIZATION PROPOSAL NO. DURATION
(MONTHS)
PRINCIPAL INVESTIGATOR (PI)/PROJECT
DIRECTOR
Instructor (N/B Name)
AWARD NO.
A. PERSONNEL: PI/PD, Co-PIs, Faculty, Graduate Assistants,
etc. Funds
List each separately with name and title. (Write your
NAME)
Proposer)
1. Instructor (N/B Name) ($90,000 annually) - 30% effort
for 5 months $11,250.00
2.Research Assistant (RA) - 80% effort for 5 months
$16,667.00
TOTAL SALARIES $27,917.00
B. EQUIPMENT (LIST ITEM AND DOLLAR AMOUNT FOR

EACH
ITEM EXCEEDING $5,000.)
None $0.00
None $0.00
TOTAL EQUIPMENT COST $0.00
C. TRAVEL 1. DOMESTIC- PI attendance at national meeting
$1,300.00
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15
2. OTHER- Travel for RA to participants home $800.00
TOTALTRAVEL $2,100.00
D. PARTICIPANT SUPPORT $1,575.00
1. STIPENDS $ 45 by 35 participants
2. TRAVEL $0.00
3.
SUBSISTENC
E

$0.00
4. OTHER $0.00
TOTAL NUMBER OF PARTICIPANTS (35) TOTAL
PARTICIPANT
COSTS
$1,575.00
E. OTHER DIRECT COSTS
1. MATERIALS AND SUPPLIES- Computer for patient
training, data
collection and analysis
$5,300.00
2. OTHER Quality of Life scale $550.00
3 OTHER Office supplies $645.00
4. OTHER (Hiring Clinical Equipment’s) $400.00
TOTAL OTHER DIRECT COSTS $6,895.00
F. TOTAL DIRECT COSTS (A THROUGH E) $38,487.00
G. TOTAL INDIRECT COSTS (F&A) (Rate = 37.5%)
$14,432.625
H. TOTAL DIRECT AND INDIRECT COSTS (F + G)
$52,919.625

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