Results of a Targeted Glaucoma Screening Project Conducted Outside Formal Healthcare Settings in Croatia

Background: Although glaucoma is a leading cause of irreversible blindness, no universally accepted screening guidelines for this condition have been developed. A nationwide glaucoma screening project was developed with the aim of raising awareness and assessing regional differences in intraocular pressure (IOP) and dry eye symptoms, as well as identifying potential risk factors among various Croatian regions. Methods: Over six months in 2023, 68 ophthalmologists conducted screening at 68 pharmacies across Croatia. IOP was measured using calibrated iCare IC200 tonometers, and dry eye symptoms were assessed using the Schein questionnaire. Results: A total of 7348 adults participated (median age: 63 years). IOP values and rates of newly detected elevated IOP varied by region. The highest maximum IOP was recorded in Continental Croatia (43.3 mmHg), followed by Zagreb. Newly discovered elevated IOP was most common in Slavonia (9.47%) and Continental Croatia (7.58%). Higher IOP was more frequently detected in younger participants and those with a family history of glaucoma. In coastal regions (Dalmatia, Istria, and Kvarner), elevated IOP showed a significant association with dry eye symptoms. Conclusions: This was the largest community-based glaucoma screening initiative in Croatia. The findings reveal notable regional differences in IOP and associated risk factors, underscoring the value of targeted community screening in raising awareness and identifying individuals at risk.