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Y. Trigo, J. Hendricks, W. Sponsel; Systematic Detection and Characterization of Glaucoma at Multiple Sites in Bexar County, Texas . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3652.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: SW Texas encompasses 22 of America's 33 counties of >60% Hispanic ethnicity. Bexar County has available health coverage for nearly all its residents through private and publicly–funded programs. Four US congressional districts covering >90% of the Rio Grande Valley converge in Bexar. Consenting residents with newly–diagnosed glaucoma may be ideal candidates for ongoing assessments of natural history and efficacy of glaucomatous disease treatment, allowing for cost analyses, vital information to guide Congressional appropriations for the treatment of glaucoma. This review of a carefully planned year–long public screening program was performed to determine whether open screenings could yield a cross–section of participants representative of the community at large, and if the prevalence of undiagnosed glaucoma among screening participants was adequate to make feasible future study of glaucomatous disease progression in Bexar County. Methods:Throughout all 4 congressional districts, 4–day screenings for glaucoma were held monthly, in a forecourt of the leading grocery retailer, (HEB stores 5,9,11,12,15,21,22,27,30,32,34,40) using an air–conditioned 60–foot Lion's Mobile Screening Unit. Each day, experienced technicians, following a detailed protocol, obtained informed consent, history, acuity, FDT C20–2, HRT II, HVF SITA 30–2 and tonometry OU. On the first and final day of each screening, ophthalmologists were present to perform slit lamp and opthalmoscopic exams, and arranged appropriate referals to community practitioners. Results:Demographic records for each store and local census data were concordant with the ethnic and social profile of those attending for screening at each location, with the number attending at each site (range 95–334; median 179) varying inversely with local median income. Among the first 2000 individuals screened (Jan–Oct 04; 57% F: 43% M), 68.2% were Hispanic, 18.8% were non–Hispanic White, and 10.3% were non–Hispanic Black. Among all attendees, 2.6% were confirmed to have glaucoma, 90% of whom were previously undiagnosed (42% severe, 27% moderate, and 31% mild). A further 0.8% of the population were deemed glaucoma suspects, and 1.8% nonglaucomatous OHTs. Conclusions:A two–year sustained screening effort of this kind could yield sufficient de novo glaucoma diagnoses to provide adequate power to compare disease progression among those taking advantage of therapy versus those electing not to, using existing standard algorithms. Bexar county may provide a suitable base for such prospective studies of glaucoma and its cost/benefit profile among Hispanic adults.
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