NHMRC Glaucoma Guidelines - ANZGIG

NHMRC GUIDELINES FOR THE SCREENING, PROGNOSIS, DIAGNOSIS, MANAGEMENT AND PREVENTION OF GLAUCOMA
Chapter 4 – The role of population screening
■ Chapter 4
The role of population screening
Recommendation 1
Screen high risk groups
Introduction
The cost-effectiveness of general population screening for glaucoma has not been clearly established.
Current literature provides no consensus regarding the timing or frequency of population screening.
Population screening does not have to be limited to glaucoma detection, as it could screen for eye
disease more broadly.
An optimal test, or group of tests for glaucoma screening has not been identified. A number
of tests are potentially feasible for detecting glaucoma in a screening program, including optic
disc assessment, visual field (VF) assessment, intraocular pressure (IOP) and angle assessment
(Burr, Mowatt, Hernández et al 2007; European Guideline Society [EGS] 2008). Guidelines suggest
that perimetry (frequency doubling technology) also shows promise as a population-screening
tool (American Academy of Ophthalmology [AAO] 2005b).
There is consensus in the literature that targeted screening of individuals at-risk of glaucoma
may be warranted. Targeted screening may be more cost-effective in specific sub-groups of the
population such as older adults, African descent populations, and those with a family history of
glaucoma. Further research is required to support this. This guideline details the evidence for risk
factors in the development and progression of glaucoma. For specific recommendations concerning
the identification of risk, refer to Chapter 6.
There is no consensus in the literature regarding which health care providers should perform
population screening. There are a number of health care providers with the skills and capacity to
perform the appropriate tests. However, should a screening schedule be proposed in the future,
local resources, inter-professional relationships, practice guidelines and legal indemnity will help
determine the most appropriate screening approach at any given location.
There is limited information regarding the use of screening in glaucoma types other than primary
open angle glaucoma.
National Health and Medical Research Council 37