Ability of non-ophthalmologist doctors to detect eyes with occludable angles using the flashlight test

Abstract

The aim of this study is to assess the ability of non-ophthalmologist doctors to detect eyes with occludable angles using the flashlight test (FLT). For this study, a total of 45 patients were prospectively enrolled. After an ophthalmological examination all patients underwent FLT by two non-ophthalmologist examiners in a masked and standardized fashion. Two gynecologists were chosen, as they often deal with patients exposed to drugs that can trigger pupillary block. An occludable angle was defined as ≥2 quadrants in which the posterior trabecular meshwork was not visible by gonioscopy without indentation (performed by an experienced glaucoma specialist). Whenever both eyes were eligible, one was randomly selected for analysis. Sensitivity and specificity for detection of occludable angles were generated, and the agreement between examiners was assessed. This study results showed that the mean age was 47.1 ± 16.4 years and most patients were female (67.7 %). There was a good agreement between observers for FLT results (κ = 0.77; p = 0.04). Similar values of sensitivity and specificity were found for both examiners (92 and 67 % vs 97 and 67 %, respectively). Based on the findings of this study, it was concluded that FLT showed good sensitivity for detection of eyes with occludable angles. The fact that it can be easily and reliably performed by non-ophthalmologist highlights its use as a screening tool in patients requiring medications that can induce angle closure.