Screening for glaucoma in geriatric medical practice using ophthalmoscopy and oculokinetic perimetry
Bruce DW., Damato BE., Williams BO., Pitts JF., Holding D.
Pre-symptomatic diagnosis of glaucoma is essential for the prevention of visual handicap but an effective screening procedure does not yet exist. Oculokinetic perimetry is a new visual field test which is reliable and suitable for nonspecialist use. Sixty admissions were examined to detect glaucoma suspects requiring further specialist assessment. Despite the high prevalence of suspicious findings no new cases of primary open angle glaucoma were detected. 22% of glaucoma suspects were not seen at the referral clinic, either because the defaulted, or moved elsewhere, or had died. Nevertheless, a high prevalence of visual handicap was observed. This study highlights the need for screening for eye disease in elderly people. Testing of visual acuity plus simple ocular examination and fundoscopy seems adequate. Only patients with unequivocal findings should be referred for specialist opinion. Perimetry by geriatricians is feasible, and useful in a relatively small number of patients with equivocal findings.