Glaucoma Screening Guidelines Worldwide.

Abstract

Recommendations for glaucoma vary significantly from organization to organization, and while worldwide screening is currently not recommended, there is support in many organizations for screening at-risk subgroups of the general population. To summarize and compare current glaucoma screening protocols of major national and international, governmental, and non-governmental organizations. A general review of the major medical, and more specifically ophthalmic, organizations within North America, South America, Europe, Asia, and Africa was undertaken. Protocols from recent international and regional meetings were reviewed and summarized and a comparative analysis was employed to highlight differences between national and regional policies. In general, it was found that worldwide screening for glaucoma is currently of limited clinical utility and unlikely to be cost-effective. However, a more targeted approach is recommended by some major organizations including the American Academy of Ophthalmology, the Pan-American Association of Ophthalmology, and the International Council of Ophthalmology in conjunction with a group of prominent ophthalmologists based in Sub-Saharan Africa recommend a targeted approach to screening specific populations that are deemed to be at higher risk of developing glaucoma. General population screening for glaucoma has been adopted as a recommendation by only a few organizations and only in specific situations. It is the screening of high-risk populations that has been demonstrated to be not only clinically useful in diagnosing and treating larger proportions of the general population benefiting from a higher positive-predictive value for screening protocols in these groups but also cost-effective. Further research is needed to create cost-effective protocols to successfully screen these high-risk populations for glaucoma using methods that are sufficiently sensitive and specific.