Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 6;14(Suppl 1):i29-i36.
doi: 10.1093/inthealth/ihab078.

Piloting targeted glaucoma screening: experiences of eye care services in Ganjam district, Odisha state, India

Sandeep Buttan  1 , Ben Gascoyne  2 , Sudeep Das  3 , Elena Schmidt  4
Affiliations

Piloting targeted glaucoma screening: experiences of eye care services in Ganjam district, Odisha state, India

Sandeep Buttan et al. Int Health. .

Abstract

Background: The number of patients with visual impairment and blindness from glaucoma is rapidly increasing with wide-ranging impacts for individuals and societies. However, the disease often goes undiagnosed for a long time, especially in low- and middle-income countries where healthcare services are limited. This paper presents the results of a pilot programme, which integrated targeted glaucoma screenings of people aged ≥40 y in community-based eye care services in the Ganjam district of Odisha state, India.

Methods: Using routine programme data, descriptive statistics were produced for the characteristics of patients participating in the screening programme and the rate and uptake of glaucoma referrals. Bivariate analysis was used to examine associations between patient characteristics, clinical risk factors and glaucoma diagnosis.

Results: Out of 23 356 individuals aged ≥40 y screened for glaucoma over a period of 18 mo, 2219 (9.5%) were referred and 2031 presented for further examination. Among them, almost half (n=968, 48%) were diagnosed with glaucoma, representing a screening to diagnosis conversion rate of 4.14% (95% CI 3.9 to 4.4%). A positive diagnosis of glaucoma among suspects was associated with female sex, age >60 y, visual impairment, vertical cap-to-disc ratio ≥0.6:1, intraocular pressure ≥30 mmHg and shallow anterior chamber (p<0.001).

Conclusions: The importance of targeted screening for glaucoma using simple referral criteria to identify patients at high risk of vision loss who can benefit from treatment is critical to slow the progression of the disease and the prevention of blindness. Further studies assessing costs of the targeted screening, the role of technology in improving programme effectiveness and efficiency and the longer term compliance with treatment are needed to support glaucoma policy frameworks, guidelines and clinical practice.

Keywords: India; community-based programme; glaucoma; screening.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Glaucoma-screening data collection tool used in the pilot.
Figure 2.
Figure 2.
The flowchart of patient screening, referral and diagnosis process.
See this image and copyright information in PMC

References

    1. McMonnies CW. Glaucoma history and risk factors. J Optometry. 2017;10(2):71–8. - PMC - PubMed
    1. Kapetanakis VV, Chan MP, Foster PJet al. . Global variations and time trends in the prevalence of primary open-angle glaucoma (POAG): a systematic review and meta-analysis. Br J Ophthalmol. 2016;100(1):86–93. - PMC - PubMed
    1. Wang W, He M, Li Zet al. . Epidemiological variations and trends in health burden of glaucoma worldwide. Acta Ophthalmol. 2019;97(3):e349–55. - PubMed
    1. World Health Organization . World report on vision. 2019. Available at: https://www.who.int/publications/i/item/9789241516570 [accessed June 7, 2021].
    1. Tham YC, Li X, Wong TYet al. . Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081–90. - PubMed

Publication types