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%.