Mass Screening for Primary Open-Angle Glaucoma: Is It Really Relevant?

Abstract

Glaucoma, one of the leading causes of blindness worldwide, poses a significant public health challenge. Despite advancements in diagnostic technologies, early detection remains a challenge. This study assesses the relevance of glaucoma screening in a population-based context. Conducted in October 2023, this retrospective study involved 434 employees at two pharmaceutical laboratory sites. The average age was 44 years, with a female-to-male ratio of 0.7. A family history of glaucoma was reported in 74 participants (17%). Intraocular pressure (IOP) measurements showed that 20 participants (4.6%) had IOP above 21 mmHg, while the average IOP in the studied population was 15.5 mmHg. Glaucomatous damage to the optic nerve head was observed in 65 cases (15%). A total of 71 employees (16.5%), including 70% women, were re-examined in a hospital setting, where they underwent comprehensive ophthalmological examinations. Among them, 13 participants (18%) were diagnosed with glaucoma, representing 2.9% of the initially screened employees. This study highlights the ongoing challenge of preventing irreversible blindness due to glaucoma. Although the diagnostic approach used was effective for early detection among employees, the overall value of mass glaucoma screening remains debated. This debate is due to the disease's low prevalence, the lack of highly sensitive and specific screening tests, economic considerations, and the impact on the quality of life of those screened. Further studies are needed to evaluate the clinical effectiveness and economic efficiency of various screening strategies.