Screening for Glaucoma in an Urban Population

The methods by which we detect glaucoma are far from perfect. In the past, measurement of eye pressure was used in health fairs, in screenings by mobile vans, and in optical shops as the “test for glaucoma”. Recent scientific studies have shown that this approach calls almost one in ten persons abnormal, even though only a minority of those with higher pressure have or will get glaucoma. Furthermore, it misses one-half of those with glaucoma. This project takes the approach that new methods for glaucoma screening should be looked for by directly examining the eye for glaucoma damage, rather than only measuring eye pressure. Six methods are to be tested on the same large group of people. Some of these methods require no effort on the part of the subject (objective) and have the advantage that even the elderly or those unable to cooperate with complex tests could be evaluated. Some are rapid and inexpensive tests that could be carried out by non-medical personnel. Others are highly technical tests with expensive instruments that would be practical if used at centralized sites such as drivers license bureaus or senior citizen centers. The large population for the study are adults residing in the community of east Baltimore, Maryland. It is particularly important that these are not experienced eye patients or health workers, but “real” people who are quite representative of those who would need to be screened in mass fashion in order to have an impact on glaucoma, which is rapidly becoming the second most important cause of blindness in the world. The long-term goal of this project is to develop for the first time effective methods to identify those with glaucoma in the U.S. and in other countries and to perfect these methods for implementation in the various settings in which they will be most useful.