Comparison of Outcomes of Glaucoma Screening in Primary Care and Community Settings

ABSTRACT

Purpose

To compare outcomes of glaucoma screening in primary care and community settings, including the follow-up rates of subjects with positive screening results.

Methods

This was a comparative, prospective, non-randomized study. Subjects were recruited by medical students in community-based and primary care settings and screened for glaucoma using the same screening strategy.

Results

Two hundred and fifteen total patients were screened, 117 in community settings and 98 in primary care settings. Positive screenings were seen in 34% of patients in the community setting group (n = 40) and 40% of patients in the primary care setting group (n = 39). Of the patients who screened positive, 74% completed their initial follow-up appointment in the primary care setting group compared with 47.5% in the community-based setting group (p = .015). In the primary care setting, 18% were lost to follow up compared with 42.5% in the community-setting (P = .018). African-Americans were more likely to follow-up (P = .025) and less likely to be lost to follow-up (P = .033) in the primary care setting compared with the community-based setting.

Conclusion

Patients with a positive glaucoma screening result in a primary care setting are more likely to follow up than those in a community-based setting.

KEYWORDS:

• Glaucoma
• screening
• primary care
• community-based
• perimetry

Acknowledgments

The authors would like to thank the medical students, ophthalmology residents, and research staff at the University of Virginia School of Medicine for their dedicated service in the screening and data collection for this project. The leadership and staff of University Medical Associates at the University of Virginia were also instrumental to the success of this study. In particular, we thank Bingjie Ling, Chang Sup Lee, Rita Page, Vandan Patel, Sumeet Gupta, Thomas Jenkins, Joshua Nun, Ankur Gupta, Nick Farber, Teresa Martz, and Chih-Huan Lu.

Declaration of interests

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The authors have no proprietary interest or conflicts to disclose.