title: Glaucoma screening during regular optician visits: the feasibility and specificity of screening in real life.
abstract: OBJECTIVE
  To determine the feasibility and specificity of glaucoma screening during regular optician visits.
  
  
  METHODS
  In four optician shops, glaucoma screening was offered to 400 consecutive visitors aged 45 years or above. If the visitor agreed to participate, an intraocular pressure measurement and - in those with a pressure below 25 mmHg - a frequency-doubling perimeter (FDT) C20-1 visual field screening test were performed. Those with an elevated pressure or at least one reproducibly abnormal test location on FDT were referred to our hospital.
  
  
  RESULTS
  Three-hundred and fifty-two of 400 consecutive visitors (88%) were screened. Fifteen of the unscreened visitors were not screened because they were already regularly checked by an ophthalmologist related to glaucoma. Forty-two of 352 screened participants (12%) were referred. Of these 42 referrals, seven were diagnosed with glaucoma, 10 were diagnosed with ocular hypertension (OHT), 12 did not have any eye disease, seven had an eye disease other than glaucoma or OHT that was diagnosed previously and six were newly diagnosed with an eye disease other than glaucoma or OHT. The specificity of the screening protocol was 91% (95% confidence interval 88-94%).
  
  
  CONCLUSIONS
  Glaucoma screening at the optician shop was feasible, but the specificity of the screening protocol was rather low. With more stringent cut-off points (30 mmHg; at least two reproducibly abnormal test locations), the specificity could be improved to 96% (94-98%), apparently without a significant loss of sensitivity. This suggests that screening during regular optician visits might be a viable approach.
authors.affiliation: Department of Ophthalmology, University Medical Center Groningen, University of Groningen, 9700 R B Groningen, The Netherlands.
authors.forename: Margriet M
authors.initials: MM
authors.lastname: de Vries
authors.forename: Remco
authors.initials: R
authors.lastname: Stoutenbeek
authors.forename: Rogier P H M
authors.initials: RP
authors.lastname: Müskens
authors.forename: Nomdo M
authors.initials: NM
authors.lastname: Jansonius
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis; D009819:Office Visits; D009907:Optometry; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014065:Tonometry, Ocular; D015351:Vision Screening / Q000379:methods* / Q000592:standards; D058609:Visual Field Tests