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  • Optimizing Glaucoma Screening in a High-Risk Population

    By Lynda Seminara and selected by Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, August 2017

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    Zhao et al. reported first-year findings of the Screening to Prevent (SToP) Glaucoma study. Not surprisingly, the results confirm that many underserved individuals have undetected ophthalmic conditions requiring medical attention.

    SToP Glaucoma is an ongoing proj­ect from the U.S. Centers for Disease Control and Prevention to implement an effective sustainable program for de­tecting glaucoma and other eye diseases in high-risk individuals. It focuses on African Americans who are 50 years old or older and live in inner-city neigh­borhoods of Baltimore. A goal of the project is to screen 9,000 individuals in a 5-year period.

    The screening process is twofold. The first part occurs in a local commu­nity venue. A questionnaire is admin­istered by trained personnel, who also assess visual acuity (VA), measure in­traocular pressure, and perform digital fundus imaging and visual field testing. Individuals with positive findings are referred for subsequent (definitive) ex­amination at the Wilmer Eye Institute. Both screenings are provided at no cost.

    Of 901 people who were screened by October 2015, 95% were African American. All told, 107 (12%) required only corrective lenses, and 356 (40%) were referred for definitive diagnosis of other suspected eye conditions. Only 43% of referred individuals followed through with the definitive exam.

    The most common reasons for referral were ungradable fundus image (39% of those referred), best-correct­ed VA worse than 20/40 (15%), and ungradable autorefraction (12%). The most common diagnoses established from definitive examination were glau­coma (51%) and cataract (40%). Based on the original study group of 901, the program’s overall yield for significant eye disease (defined as glaucoma, cata­ract, diabetic retinopathy, or age-related macular degeneration) was approxi­mately 15%.

    The original article can be found here.