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O. Kosoko–Lasaki, Sr., J. Rowe, V. Haynatzka; Screening for Primary Open Angle Glaucoma in Rural Nebraska . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3455.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the effectiveness of glaucoma screening in outreach programs in rural Nebraska.
A retrospective review was performed of patients participating in glaucoma screening programs at various locations in rural Nebraska between March 2004 and January 2005. All participants completed screening forms provided by the Congressional Glaucoma Caucus. Interpreters were used for Spanish speaking individuals. Demographic data like age, gender, and race were documented. In addition, past medical history, type of diabetes, use of insulin and duration of disease, and elevated blood pressure and duration of disease were detailed. Family history of glaucoma and duration of disease, time since last eye examination and greater than 4.0 diopters of nearsightedness were also recorded. Each patient underwent a screening eye exam: visual acuity, intraocular pressure (IOP), and visual field testing. Visual acuity was assessed separately in each eye with or without correction. IOP was measured using a handheld Tonopen. Visual field was assessed with the Frequency Doubling Testing (FDT) machine. Patients were grouped into three categories: glaucoma suspect, cataract suspect, and other ocular disease. Recommendations were made based on the ocular exam. This included urgent glaucoma consultation, non–urgent glaucoma consultation, ophthalmic consultation, and routine follow–up exam.
The majority of patients, 40.5%, were Caucasian, while 25.7% were Hispanic, 16.5% were African American, 2.0% were Asian and 7.3% were unclassified "other". 7.3% of patients had hypertension, while 5.8% had diabetes. A family history of glaucoma was present in 8.1% of patients, and 1.7% reported having a personal history of glaucoma. Most of the subjects had vision in the 20/20–20/40 range. 70.8% of individuals could not recall the "last time they had an eye exam". 10.8% and 11.8% of patients had suspicious visual field tests in the right and left eyes, respectively. 9.2% and 8.9% had abnormal visual field results in the right and left eyes, respectively. Based on the above testing, 14.7% of patients were considered glaucoma suspects in the right eye and 15.9% were considered glaucoma suspects in the left eye.
The rural Nebraska glaucoma outreach program supported by the Congressional Glaucoma Caucus Foundation at Creighton University has successfully identified majority of patients at risk or currently suffering from glaucoma. Recommendations and referrals for ophthalmic care were made to all individuals as needed.
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