Importance of questionnaires and screening tonometry for early detection of glaucoma

PURPOSE. To evaluate the diagnostic effectiveness of questionnaires in combination with tonometry at the first stage of screening for early detection of glaucoma.

METHODS. The study analyzed a group of 640 people who applied for intraocular pressure (IOP) measurement. All subjects filled out a questionnaire aimed at identifying risk factors for glaucoma, and had non-contact tonometry (Reichert 7 CR) measurement taken. Of these, 238 people had normal IOP level and no risk factors. The remaining 402 people (with elevated IOP and/or risk factors — 4 points or more on the questionnaire) underwent a comprehensive examination, including tonometry using various methods, Pulsar perimetry, optical coherence tomography of the posterior segment of the eye with analysis of the ganglion cell complex, ophthalmologist's examination.

RESULTS. At the stage of pre-medical tonometry, IOP of 21 mm Hg and below was recorded in 216 people (53.7%), 22–28 mm Hg — in 139 (34.5%), 29 mm Hg and above — in 47 (11.6%). During a comprehensive examination, IOP up to 21 mm Hg was detected in 151 people (37.5%), 22–28 mm Hg — in 214 (53.2%), 29 mm Hg and above — in 37 (9.2%). Of the 402 examined, glaucoma was diagnosed in 178 patients (44.1%), glaucoma/ocular hypertension was suspected in 139 (34.5%), and in 85 (21.1%) no glaucomaspecific data was found. At the same time, among 186 people with elevated IOP without risk factors, glaucoma was detected in 30.5% of cases, and glaucoma/ocular hypertension was suspected in 14.9% of cases. In total, of the 640 people who applied to the pre-medical tonometry measurement, glaucoma was detected in 178 (27.8%), and glaucoma/ocular hypertension was suspected in 139 (21.7%). Early glaucoma was detected in 94 cases (52.8%), moderate glaucoma in 63 (35.5%), and advanced glaucoma in 21 (11.7%). No cases of advanced glaucoma were detected among those selected for a comprehensive examination based on the results of the questionnaire.

CONCLUSION. The use of questionnaires in addition to pre-medical tonometry increased the detection rate of glaucoma from 30.5% to 44.4%, and the group of patients with suspected glaucoma/ocular hypertension increased from 14.9% to 34.3%.

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