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Related Experiment Videos

The value of screening for glaucoma with tonometry.

D M Eddy, L E Sanders, J F Eddy

    Survey of Ophthalmology
    |November 1, 1983
    PubMed
    Summary

    Schiotz tonometry screening for glaucoma in asymptomatic adults over 40 is not cost-effective. This method misses many glaucoma cases and early diagnosis shows limited impact on patient outcomes.

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    Area of Science:

    • Ophthalmology
    • Public Health
    • Health Economics

    Background:

    • Glaucoma is a leading cause of irreversible blindness.
    • Elevated intraocular pressure (IOP) is a primary risk factor for glaucoma.
    • Current screening methods like Schiotz tonometry have limitations in detecting all glaucoma cases.

    Purpose of the Study:

    • To estimate the cost-effectiveness of using Schiotz tonometry for glaucoma detection in asymptomatic individuals.
    • To evaluate the value of early glaucoma diagnosis through tonometry screening.

    Main Methods:

    • Analysis of data on the prevalence of elevated IOP and glaucoma in asymptomatic adults over 40.
    • Estimation of screening costs, including diagnosis and treatment.
    • Calculation of cost per patient benefited.

    Main Results:

    • Approximately 9% of adults over 40 may have elevated IOP on tonometry.
    • 1 in 50 individuals with elevated IOP are diagnosed with glaucoma.
    • Tonometry misses about 50% of glaucoma patients due to normal IOP at testing.

    Conclusions:

    • Screening asymptomatic adults over 40 with Schiotz tonometry is not a warranted public health strategy.
    • The cost per patient benefited is substantial, estimated at $13,000.
    • Earlier diagnosis via tonometry does not significantly alter patient outcomes.

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