title: The Philadelphia Glaucoma Detection and Treatment Project: Detection Rates and Initial Management.
abstract: To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma.
  
  
  
  Retrospective analysis.
  
  
  
  A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia.
  
  
  
  Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario.
  
  
  
  Detection rates of glaucoma-related diagnoses and types of treatments administered.
  
  
  
  Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT, and 103 (6.2%) who were prescribed IOP-lowering medication.
  
  
  
  Targeting individuals at risk for glaucoma in underserved communities in Philadelphia yielded a high detection rate (39.1%) of glaucoma-related diagnoses. Providing examinations and offering treatment, including first-line laser procedures, at community-based sites providing services to older adults are effective to improve access to eye care by underserved populations.
authors.affiliation: Wills Eye Hospital Glaucoma Research Center, Philadelphia, Pennsylvania. Electronic address: MWaisbourd@willseye.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Waisbourd
authors.affiliation: Wills Eye Hospital Glaucoma Research Center, Philadelphia, Pennsylvania.
authors.forename: Noelle L
authors.initials: NL
authors.lastname: Pruzan
authors.affiliation: Wills Eye Hospital Glaucoma Research Center, Philadelphia, Pennsylvania.
authors.forename: Deiana
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Wills Eye Hospital Glaucoma Research Center, Philadelphia, Pennsylvania.
authors.forename: Angela
authors.initials: A
authors.lastname: Ugorets
authors.affiliation: Vision Health Initiative, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: John E
authors.initials: JE
authors.lastname: Crews
authors.affiliation: Vision Health Initiative, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jinan B
authors.initials: JB
authors.lastname: Saaddine
authors.affiliation: Lewis Katz School of Medicine at Temple University, Department of Ophthalmology, Philadelphia, Pennsylvania.
authors.forename: Jeffery D
authors.initials: JD
authors.lastname: Henderer
authors.affiliation: Wills Eye Hospital Glaucoma Research Center, Philadelphia, Pennsylvania.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Hark
authors.affiliation: Wills Eye Hospital Glaucoma Research Center, Philadelphia, Pennsylvania.
authors.forename: L Jay
authors.initials: LJ
authors.lastname: Katz
mesh_terms: D001741:Black or African American / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D063171:Corneal Pachymetry; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy; D015143:Philadelphia / Q000453:epidemiology; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents