Glaucoma
| Age | 0 - 9 | 10 - 14 | 15 - 19 | 20 - 24 | 25 - 29 | 30 - 34 | 35 - 39 | 40 - 44 | 45 - 49 | 50 - 54 | 55 - 59 | 60 - 64 | 65 - 69 | 70 - 79 | >80 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
There is insufficient evidence to recommend routine screening for glaucoma using tonometry or visual fields test (C).455 However, GPs have an essential role in identifying patients at higher risk for glaucoma, and referring them for testing.
| Who is at higher risk of glaucoma? | What should be done? | How often? | Level of evidence and references |
|---|---|---|---|
Increased risk Patients with:
|
Refer for ophthalmoscopy, tonometry and visual field assessment* |
Every 12 months |
III C 456 |
| Intervention | Technique | References |
|---|---|---|
| Tonometry | Tonometry is not recommended. Schiotz tonometry has poor sensitivity and specificity for early detection of glaucoma. Tonometry is an inadequate screening tool as it grossly overestimates glaucoma prevalence (C) | |
| Perimetry (visual fields) | Not advisable in general practice as only automated perimetry is sensitive for detecting glaucoma (C) | 458,548 |
| Fundus (ophthalmoscopy) | There is some evidence that new generation (panoptic) ophthalmoscopes can better detect glaucomatous discs as well as macular degeneration and diabetic retinopathy (B) | 459 |
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