Screening for glaucoma using intraocular pressure alone

Jampel, Henry D.

doi:10.1136/bmj.j4160

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…It is important to note that the purpose of our study was not to diagnose glaucoma; we measured IOP only and there was no attempt to use other tests or combinations of tests with the potential to detect glaucoma. The diagnostic capability of an IOP measurement alone is poor and hence formal diagnosis of glaucoma is based on the results from an array of tests, including tonometry, assessment of the optic nerve head, VF assessment, pachymetry and assessment of the anterior chamber angle, most commonly determined by gonioscopy 5 8 17 37 38. Although the diagnosis of glaucoma was not the purpose of the Pop-Up, we aimed to inform people in the shopping centres of the importance of measuring IOP and having regular eye examinations; we speculate this information could lead to possible long-term benefits in terms of their ocular health.…”

Section: Discussionmentioning

confidence: 99%

Feeling the pressure: a cross-sectional study exploring feasibility of a healthcare Pop-Up for intraocular pressure measurements in shopping centres in England

et al. 2019

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ObjectivesTo test the hypothesis that a shopping centre Pop-Up health check combining an intraocular pressure (IOP) check with a general health check (blood pressure (BP)) is more readily accepted by the general public than an IOP check only. We investigate public awareness of IOP compared with BP and the feasibility of measuring IOP in large numbers in a Pop-Up.DesignA cross-sectional study using a tailor-made healthcare Pop-Up.SettingThe ‘Feeling the Pressure’ Pop-Up was sited in eight regionally-different shopping centres in England.ParticipantsAdult members of the public in shopping centres.MethodsOn one day we measured IOP only and on another measured BP and IOP. IOP was measured by Icare IC100 tonometer (Helsinki, Finland). Potential participants were asked about their awareness of IOP and BP and when they last visited their optometrist.ResultsMore people attended the combined BP + IOP days (461; 60%; 95% CI 56% to 64%) than IOP-only days (307; 40%, 95% CI 37% to 43%) over 16 days of testing. We recorded IOP in 652 participants (median (IQR) age and IOP of 54 (42 to 68) years and 13 (11 to 15) mm Hg, respectively). Fewer people reported awareness about IOP (19%, 95% CI 16% to 23%) compared with BP (71%, 95% CI 66% to 75%). Of 768 participants, 60 (8%) reported no previous optometric eye examination and 185 (24%) reported >2 years since their most recent examination.ConclusionsMeasuring IOP in large numbers of the public via a shopping centre Pop-Up is feasible. Public engagement was greater when a BP check was offered alongside an IOP check, suggesting unfamiliar health checks can be promoted by aligning them with a more familiar check. Our findings hint at strategies for public health schemes that engage the public with their eye health.

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Section: Discussionmentioning

confidence: 99%

Feeling the pressure: a cross-sectional study exploring feasibility of a healthcare Pop-Up for intraocular pressure measurements in shopping centres in England

et al. 2019

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“…This therefore reveals the de iciencies inherent in using only IOP as a screening tool for glaucoma. Jampell [15] found up to 76% of people had IOP <21mmHg and so would be missed by IOP screening alone.…”

Section: Discussionmentioning

confidence: 99%

Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Awoyesuku¹,

Chukwuka²

2018

Int J Clin Exp Ophthalmol

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To determine the proportion of participants with elevated intraocular pressure and abnormal vertical cup disc ratio in a glaucoma screening event in a rural community in Nigeria. Methods: 242 eyes of 121 participants at a one-day screening programme were examined. Visual acuity was accessed using Snellen literate and illiterate charts, followed by a pen torch examination of the anterior segment. The posterior segment was accessed using a direct ophthalmoscope (Welch Allyn, USA). All participants had intraocular accessed using Keeler non contact tonometer and those with signifi cant media opacity preventing view of the posterior pole had cycloplegic examination after dilatation with 1%Tropicamide drops. Data generated was expressed as percentages and means. Results: 121 participants (242 eyes) were examined. There were 42 males and 79 females giving a M:F ratio of 1:1.86. Age range of participants was 0-90years with a peak in the 5th decade. Mean age was 32 years. 79.3% of participants had normal visual acuity of 6/4-6/18, while 9.5% had visual acuity worse than 6/60. 83% of eyes had intraocular pressure within normal level, <21mmHg, 12.4% within 21-30mmHg and 4.6% >30mmHg. 73.1% of eyes had Vertical Cup disc ratio (VCDR) <0.5, 10.7% had 0.5-0.7 and 6.6%>0.7. 9.6% of eyes could not be accessed due to media opacities. Conclusion: 6.6% of participants had suspicious discs and 4.6% participants had intraocular pressures above 30mmHg. Opportunistic screening for glaucoma remains one of the important modes of case detection for glaucoma in the developing climes and should be encouraged as a way to address the scourge of this blinding disease.

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“…Notwithstanding, early diagnosis is difficult to realize as the apoptosis of RGCs starts before the onset of visual field loss [8]. Although IOP elevation is a common clinical feature in glaucoma patients, there is a dearth in the reliance on distinguishing glaucoma based on an IOP threshold [9,10]. Therefore, currently, effective IOP reduction is a more feasible approach than achieving an early diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

Chen

Lin

et al. 2021

Contact Lens and Anterior Eye

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A large fluctuation in intraocular pressure (IOP) and a high peak IOP remain the risk factors for progressive visual field loss in patients with glaucoma, which is a leading cause of irreversible blindness. However, IOP measurements during working time cannot provide sufficient information on IOP to guide clinicians in setting IOP target values. Contact lenses are extensively used in ophthalmology to correct the refractive error, and recently, they are serving as platforms for detection and drug delivery. Contact lens sensor (CLS) is a feasible and promising approach to continuously monitor IOP, with superior tolerance, non-invasiveness, and without sleep disturbance. The present work reviewed the associations between progressive course and Triggerfish® CLS outputs as well as the relationship between treatments and Triggerfish® CLS outputs. Moreover, it further summarized state-of-the-art CLS devices of the past decade.

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Screening for glaucoma using intraocular pressure alone

Abstract: An outdated concept that should be abandoned

Cited by 3 publications

References 8 publications

Feeling the pressure: a cross-sectional study exploring feasibility of a healthcare Pop-Up for intraocular pressure measurements in shopping centres in England

Feeling the pressure: a cross-sectional study exploring feasibility of a healthcare Pop-Up for intraocular pressure measurements in shopping centres in England

Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Outcome, influence factor and development of CLS measurement in continuous IOP monitoring: A narrative review

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