title: Screening for glaucoma in a medical clinic with photographs of the nerve fiber layer.
abstract: OBJECTIVE
  To evaluate nerve fiber layer photography as a method for glaucoma screening in a general medical clinic setting.
  
  
  METHODS
  One hundred seventy-one persons who attended an academic hospital medical clinic were administered a questionnaire and underwent a complete eye examination, including automated perimetry and photography of the optic disc and nerve fiber layer.
  
  
  RESULTS
  Eighteen patients were diagnosed as having primary glaucoma; one, secondary glaucoma; and 21 were suspected of having glaucoma. Nerve fiber layer photographs were taken on 145 persons (85%) and were readable in 136 (80%) of the sample of 171 subjects. Nerve fiber layer atrophy was detected on masked evaluation in 64% of those with glaucoma, in 28% of those suspected of having glaucoma, and in 16% of persons who did not meet the criteria for glaucoma.
  
  
  CONCLUSIONS
  Nerve fiber layer photography can be carried out as a screening method and can identify a substantial proportion of those with glaucoma. It compares favorably with tonometry, cup-disc ratio estimation, or screening visual field examination for glaucoma detection.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Md.
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.forename: H A
authors.initials: HA
authors.lastname: Quigley
authors.forename: J M
authors.initials: JM
authors.lastname: Tielsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005654:Fundus Oculi; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology; D009900:Optic Nerve / Q000473:pathology*; D010044:Outpatient Clinics, Hospital; D010781:Photography / Q000379:methods*