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Margriet M. De Vries, Remco Stoutenbeek, Rogier P. Müskens, Nomdo M. Jansonius; Glaucoma Screening during Regular Optician Visits - the Feasibility and Specificity of Screening in Real Life. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5053.
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To determine the feasibility and specificity of glaucoma screening performed during regular optician visits.
Four opticians performed glaucoma screening on 400 consecutive optician shop visitors aged 45 years or above. Following a strict protocol, they performed a non-contact intraocular pressure measurement and - in those with a pressure below 25 mmHg - an FDT C20-1 visual field screening test. Those with an elevated pressure (25 mmHg or above) or an abnormal FDT test result (at least one abnormal test location that persisted at retest) were referred to our hospital and we performed a full ophthalmic examination including standard automated perimetry.
Three-hundred-fifty-two of 400 consecutive visitors (88%) were screened; 48 were not screened for various reasons. Forty-two of 352 participants (12%) were referred. Six of these 42 referrals (14%) were newly diagnosed with glaucoma. Their median age was 77 years (range: 62 to 87 years); the median standard automated perimetry (Humphrey Field Analyzer 30-2) mean deviation of their worse eye (6 eyes) was -7.4 dB (range -3.4 to -15.7 dB) and of their better eye (6 eyes) -5.3 dB (range -0.4 to -12.3 dB). Nine of the referrals (21%) were newly diagnosed with ocular hypertension (OHT); one referral (2%) had a previously diagnosed OHT. Of the remaining 26 referrals, 12 (29%) did not have any eye disease. Seven referrals (17%) had an eye disease other than glaucoma or OHT that was diagnosed previously and six referrals (14%) were newly diagnosed with an eye disease other than glaucoma or OHT. One referral (2%) was thus far inconclusive.
Eighty-eight percent of the screened population was not referred, yielding an upper limit of the specificity of the screening protocol of 88%. Glaucoma was newly diagnosed in about 2% of the screened population. In the remaining 10%, the ophthalmic consultation was considered worthwhile in about 40%.
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