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A. Wegner, G. Zahlmann; Internet Based Glaucoma Screening . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3417.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To develop an internet based glaucoma screening program with an integrated quality assurance system. Methods: A population based glaucoma screening was performed. To screen was the intraocular pressure (IOP) measured with a Goldmann applanation tonometer and a mobile Heidelberg Retinal Tomograph (HRT) II unit to evaluate the optic disc. A glaucoma screening tele-ohthalmological platform – Medstage - was developed (on line medial history, examination data, quality assurance and operator quality control). An internet based organiser, open to the public for self-determination of the screening visit was used. There was an on line continuos operator quality control. A special training program for the operators was designed. All gathered data was sent to the central Medstage server. 10% of all normal HRT examinations, all borderline and all abnormal examinations underwent a second evaluation as part of a quality assurance procedure. Results: The screening was performed in 13 different sites in the Munich area. 1733 people were screened during a 6 months period. The mean screening time was 15 minutes. In the quality assurance process 434 normal, 155 borderline and 61 abnormal HRT examinations – 20% of all – were included. Before quality assurance 7% had borderline HRT examination and 3% abnormal. After quality assurance 5% were classified as borderline and 2% abnormal. 4 examinations were upgraded and 57 were downgraded. 56(3.3%) people had an IOP>22mmHg. 45(2.7%) people had an abnormal HRT. 3 people had abnormal HRT and IOP>21mmHg. Conclusions: A internet based glaucoma population screening is applicable. Quality assurance can reduce significantly the false positive cases. The efficacy of a glaucoma screening program is increased when using two different diagnostic tools.
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