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Glaucoma screening by optometrists

机译:Glaucoma screening by optometrists

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Studies undertaken in the United Kingdom have indicated that optometrists are responsible for the initial detection of most cases of glaucoma and are much more efficient at screening for glaucoma than general practitioners. In this study we were interested in determining how optometrists screened for glaucoma. This was undertaken by sending a survey to 50 registered optometrists practising in the Brisbane area to derive information on facilities available for glaucoma screening, modes of testing and on criteria adopted for referral of patients. The response rate was 60 per cent to the first section of the survey and 42 per cent to the second, and more detailed section of the survey.The results demonstrated that all respondents have facilities for screening by tonometry and ophthalmoscopy, with 73 per cent also having facilities for visual field testing. All responding optometrists undertake optic disc examination on all patients. Intraocular pressure (IOP) was measured on all patients aged 40 years and over, with selective testing of those patients less than 40 years of age, depending on disc appearance, visual fields and family ocular history (FOH) of glaucoma. Visual fields were tested selectively, depending on disc appearance, IOP, age and FOH of glaucoma.Seventy‐six per cent of respondents would refer for IOP>24 mm Hg if optic discs were normal, whereas if optic discs were suspicious, 90 per cent would refer for an IOP>21 mm Hg. All indicated that they would test visual fields of patients with IOP>25 mm Hg, irrespective of disc appearance or FOH of glaucoma. The majority of optometrists would refer for characteristic field losses, for optic disc changes including a C/D ratio>0.6 or a C/D asymmetry of 0.2 or 0.3.The results indicate that optometrists are aware of the risk factors and subtle changes associated with glaucoma and would detect most patients with glaucoma. Accepted for publication: 30 August 1993 (Clin Exp Optom1993; 76:6:199–

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