Pressure points: detecting glaucoma

31 January 2022
Winter 2022

Adrian O’Dowd looks at why glaucoma is still undetected in some cases and how optometrists can sharpen up their practice.

Glaucoma early detection and diagnosis rates are widely held to be inadequate. This is all the more worrying given that the COVID-19 pandemic has led to a sharp rise in waiting times for people with glaucoma to be seen and reviewed in order to minimise their condition.

Recent research concludes that the risk factors for previously undiagnosed primary open angle glaucoma (POAG) highlight the chances of missing glaucoma among cases of lower intraocular pressure (IOP) (Chan et al, 2021).

The EPIC-Norfolk Eye Study, carried out between 2004 and 2011, examined the prevalence and characteristics of glaucoma and distribution of IOP in almost 9,000 study participants.

Researchers found that 4% of participants had glaucoma in either eye, made up of 87% with POAG, and the remainder with suspected glaucoma and/or ocular hypertension.

In 76% of patients with newly diagnosed POAG, the average IOP was under the threshold for ocular hypertension (21mmHg), so researchers concluded that IOP on its own was a poor screening tool for glaucoma with insufficiently high sensitivity for diagnosing the condition (Chan et al, 2017).

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