[Mass screening for glaucoma].

Abstract

Mass-screening of the population over 40 years by tonometry is not recommended for developed countries. However, tonometry of each patient attending the ophthalmologist, is absolutely necessary. Omitting tonometry is only justified, if special reasons prevent it, for example inflammations. If reading-glasses are always prescribed by the ophthalmologist and tonometry is done on each such patient, then this is the adequate and sufficient protection of the population against glaucoma blindness. Preventive examinations of the group in the highest danger to become blind from glaucoma, i.e. persons of 55-65 years of age, might perhaps be useful, if the tonometric limit is set high (30 mmHg) and if a check of the visual field by the Friedman-Analyzer is combined with tonometry. The aim of such examinations would not be the detection of suspicious or very early forms (tonometric glaucoma), but to screen for definite glaucoma cases with field-defects, which undetected would become blind. It seems, however, questionable, if the motivation of this age group will be sufficient. This should be found out by pilot-tests. In developing countries the question of mass-screening is entirely different. There glaucoma patients must be filtered out, in whom surgery is less risky than waiting without treatment. This can only be done by mass-screening including tonometry by the borderline-tonometer glaucotest, perimetry by the Friedman-Analyzer and estimation of the cup/disc-ratio.