Abstract
Objective To validate and analyse the usefulness of the flashlight test (FT) in detecting eyes with a shallow anterior chamber in diabetic patients in primary care. Design Cross-sectional descriptive study. Setting Urban health centre and a reference ophthalmology department, Logroño, Spain. Participants A total of 74 patients with diabetes type 2, selected by consecutive sampling from those seen for an annual check-up. Those patients with movement difficulties, diseases and lesions of the eye, which would hamper the examination, were excluded. A total of 145 eyes were analysed. Intervention A family doctor and the resident performed the FT. The ophthalmologist carried out the Van Herick test without knowing the results of the FT. Primary outcomes Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. The reproducibility was calculated using weighted kappa index. Results The kappa index was 75%. The specificity was 88.9% and the sensitivity was 98.9% (95% confidence interval (95% CI) 96.1–100.0%). The likelihood that a patient had a negative result could have an angle with a risk of developing glaucoma was 1.1%. The negative likelihood ratio (NLR) was 0.67%. One patient was incorrectly labelled as not having a narrow angle. Conclusions The FT is valid and useful for ruling out shallow anterior chamber in type 2 diabetics. It is a simple and innocuous test that can help the family doctor make a decision on pharmacological mydriasis to observe the back of the eye.
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