Screening of Glaucoma in High-Risk Minority Populations.

Abstract

Precis: This chapter reviews the current recommendations on screening for open angle glaucoma in Black and Hispanic populations. Strategies for increasing case-finding and decreasing cost, with emphasis on evolving technologies, are presented.

Purpose: To address the current recommendations on primary open angle glaucoma screening in high-risk minority populations and to discuss potential strategies to improve the screening of glaucoma in these populations.

Methods: A literature review was performed by searching PubMed, EMBASE, and Google Scholar. All English-language papers that resulted from the search terms from January 1980 to October 2023 were reviewed.

Results: In the next few decades, the societal burden of glaucoma will increase because of the demographic shift to an older and more diverse US population, including Black and Hispanic populations, which have been shown to have a higher prevalence of the disease. The current (2022) conclusion of the US Preventive Services Task Force is that the evidence to assess the balance of benefits and harms of screening for glaucoma in adults is insufficient to recommend widespread screening. The Preferred Practice Pattern guideline similarly states that screening for glaucoma in the general population is not cost-effective. However, the guidelines state that screening is more useful and cost-effective when it is targeted at populations at high risk for glaucoma, such as older adults, those with a family history of glaucoma, and Black and Hispanic individuals. Strategies for improving the effectiveness of glaucoma screening must increase case finding and decrease cost. New screening technologies, such as telemedicine and artificial intelligence, are expanding access for underserved populations.

Conclusions: There is still no clear consensus on the effectiveness of glaucoma screening for the general population. However, glaucoma screening may be useful and cost-effective when it is targeted at populations at high risk for glaucoma, particularly using emerging technologies that improve access and case-finding.