Optimizing Glaucoma Screening in High-Risk Population: Design and 1-Year Findings of the Screening to Prevent (SToP) Glaucoma Study

Am J Ophthalmol. 2017 Aug:180:18-28. doi: 10.1016/j.ajo.2017.05.017. Epub 2017 May 24.

Abstract

Purpose: To develop, implement, and evaluate a replicable community-based screening intervention designed to improve glaucoma and other eye disease detection and follow-up care in high-risk populations in the United States. We present the design of the study and describe the findings of the first year of the program.

Design: Prospective study to evaluate screening and follow-up.

Methods: This is an ongoing study to develop an eye screening program using trained personnel to identify individuals with ophthalmic needs, focusing on African Americans ≥50 years of age at multiple inner-city community sites in Baltimore, Maryland. The screening examination uses a sequential referral approach and assesses presenting visual acuity (VA), best-corrected VA, digital fundus imaging, visual field testing, and measurement of intraocular pressure.

Results: We screened 901 individuals between January 2015 and October 2015. Subjects were mostly African Americans (94.9%) with a mean (standard deviation) age of 64.3 (9.9) years. Among them, 356 (39.5%) participants were referred for a definitive eye examination and 107 (11.9%) only needed prescription glasses. The most common reasons for referral were ungradable fundus image (39.3% of those referred), best-corrected VA < 20/40 (14.6%), and ungradable autorefraction (11.8%). Among people referred for definitive examination, 153 (43%) people attended their scheduled examination. The most common diagnoses at the definitive examination were glaucoma and cataract (51% and 40%, respectively).

Conclusions: A large proportion of individuals screened required ophthalmic services, particularly those who were older and less well educated. To reach and encourage these individuals to attend screenings and follow-up examinations, programs could develop innovative strategies and approaches.

MeSH terms

  • Aged
  • Algorithms
  • Baltimore / epidemiology
  • Black or African American / ethnology
  • Cataract / diagnosis
  • Cataract / ethnology
  • Community Health Services / organization & administration
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / diagnosis*
  • Glaucoma, Open-Angle / ethnology
  • Glaucoma, Open-Angle / prevention & control*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Research Design
  • Tonometry, Ocular
  • Vision Disorders / diagnosis
  • Vision Disorders / ethnology
  • Vision Screening
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology