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Design of low cost glaucoma screening
A G Niessen1, C T Langerhorst, H C Geijssen
1Glaucoma Center, Department of Ophthalmology, University of Amsterdam, The Netherlands.
Documenta Ophthalmologica. Advances in Ophthalmology
|January 1, 1997
Summary
A 1991 glaucoma screening survey in the Netherlands evaluated low-cost methods for detecting glaucoma in adults over 49. The study identified 16 new glaucoma cases, suggesting cost-effective screening is feasible.
Area of Science:
- Ophthalmology
- Public Health
- Screening Technologies
Background:
- Glaucoma is a leading cause of irreversible blindness worldwide.
- Early detection through cost-effective screening is crucial for managing glaucoma.
- Evaluating novel screening settings can improve accessibility and reduce healthcare burdens.
Purpose of the Study:
- To assess the effectiveness and cost-efficiency of a low-cost glaucoma screening program.
- To identify potential glaucoma cases in individuals over 49 years of age.
- To determine the feasibility of using non-ophthalmologically trained personnel for screening.
Main Methods:
- A 8-day screening survey involving 1259 subjects aged over 49.
- Utilized visual field analysis (Henson CFS3000), retinal nerve fiber layer photography, intraocular pressure measurement (non-contact tonometer), and anterior chamber depth assessment.
- Follow-up examinations by a glaucoma specialist for subjects with suspected abnormalities.
Main Results:
- 56 subjects (4.4%) showed glaucomatous defects.
- 16 new cases of glaucoma were diagnosed after specialist re-examination.
- Intraocular pressure above 21 mm Hg was found in 5.3% of subjects; no angle closure glaucoma cases were identified.
- Estimated cost per screen was F1. 48.60, with potential reduction to F1. 16,- per screen for future mobile units.
Conclusions:
- Low-cost glaucoma screening settings are effective in identifying individuals with potential glaucoma.
- Future screening programs could be streamlined using non-contact tonometry and visual field analysis, potentially by non-medical staff.
- Optimized screening strategies can significantly reduce costs per case detected.