Routine glaucoma screening program may benefit middle-age African-American patients

Implementing a routine national glaucoma screening program for middle-age African American patients may be clinically effective; however its potential effect on reducing visual impairment and blindness may be modest, according to a computer-based mathematical model reported in the March issue of Archives of Ophthalmology.

"Primary open-angle is a chronic, degenerative disease that affects more than 2.2 million Americans and 1.9 percent of Americans older than 40 years," the authors write as background in the study. "The high prevalence of undiagnosed glaucoma contributes to visual loss, an outcome that is disproportionately common in African American individuals, where as many as 11 percent of elderly patients develop blindness."

Using data from the Eye Diseases Prevalence Research Group and Baltimore Eye Study, Joseph A. Ladapo, M.D., Ph.D., then of Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, now with NYU Langone Medical Center, New York, and colleagues developed a microsimulation computer-based model to project visual outcomes among African American individuals screened for glaucoma under a national .

Based on the developed , the authors found that a universal, community-based glaucoma screening program for African American patients is potentially clinically effective; however, its overall potential effect on visual impairment and blindness appears relatively modest. The authors predict that a glaucoma for between the ages of 50 and 59 years without known glaucoma would reduce the lifetime prevalence of undiagnosed glaucoma from 50 percent to 27 percent, the prevalence of glaucoma-related visual impairment from 4.6 percent to 4.4 percent, and would reduce the prevalence of glaucoma-related blindness from 6.1 percent to 5.6 percent.

The projected cost as outlined by the authors would be $80 per individual screened, considering only the cost of frequency-doubling technology and eye examinations to confirm the diagnosis. The number of patients needed to screen to diagnose one person with glaucoma was estimated at 58, and the number needed to screen to prevent one person from developing visual impairment was estimated at 875. The authors also note that they did not consider "the cost of visual rehabilitation, disability or long-term care in patients with blindness, which are substantial."

"We conclude that routine screening for glaucoma in African American individuals is a potentially clinically effective and economical method to reduce the burden of glaucoma-related visual impairment and blindness, though its absolute benefit is likely to be modest," the authors write. "Future studies should also consider long-term costs associated with treatment and the impact of delaying on health-related quality of life."

More information: Arch Ophthalmol. 2012;130[3]:365-372.

add to favorites email to friend print save as pdf

Related Stories

Vision loss more common in people with diabetes

Oct 13, 2008

Visual impairment appears to be more common in people with diabetes than in those without the disease, according to a report in the October issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Recommended for you

Looking ahead: Whole eye transplant under development

22 hours ago

The concept of a whole eye transplant seems futuristic, if not impossible. But with a $1million grant from the U.S. Department of Defense, researchers at University of California, San Diego School of Medicine hope to someday ...

A second look at glaucoma surgery

Sep 18, 2014

New research led by Queen's University professor Robert Campbell (Ophthalmology) has revealed using anti-inflammatory medications after glaucoma laser surgery is not helpful or necessary.

Stem cells have potential to repair diseased corneas

Sep 18, 2014

Corneal transplant (keratoplasty) is a known means of successfully treating corneal disease. However, without unlimited donor corneas, researchers say there is a need to study alternate methods of treatment ...

User comments