CLINICAL SUMMARY OF U.S. PREVENTIVE SERVICES TASK FORCE RECOMMENDATION

PopulationAsymptomatic adults
RecommendationNo recommendation.
Grade: I (Insufficient Evidence)
Risk AssessmentThe primary risk factor for developing primary open-angle glaucoma (POAG) is increased intraocular pressure. Other important risk factors are family history, older age, and being of African American descent. Additional risk factors may include decreased central cornea thickness, low diastolic perfusion pressure, diabetes, and severe myopia.
Screening TestsThe diagnosis of POAG is not made on the basis of a single test, but on the finding of characteristic degenerative changes in the optic disc, along with a loss of visual field sensitivity.
Perimetry assesses visual field loss by mapping a patient’s response to visual stimuli presented in various locations within the visual field. Perimetry may be performed by manual or automated methods.
Several consistent perimetry measurements are needed to establish the presence of defects.
Dilated opthalmoscopy or slit lamp examinations are used by specialists to examine changes in the optic disc; however, there is wide variability in its reliability for detecting glaucomatous optic disc progression.
InterventionsThe primary treatments for POAG reduce intraocular pressure; these include medications, laser therapy, or surgery. These treatments can effectively reduce the development and progression of small visual field defects. However, their effectiveness in reducing impairment in vision-related function is uncertain. Harms caused by these interventions include formation of cataracts, harms resulting from cataract surgery, and harms of topical medication.
Balance of Benefits and HarmsBecause of the uncertainty of the magnitude of benefit from early treatment and given the known harms of screening and early treatment, the USPSTF could not determine the balance between the benefits and harms of screening for glaucoma.
Other Relevant USPSTF RecommendationsThe USPSTF has also made a recommendation on screening for impaired visual acuity in older adults. This recommendation is available at http://www​.uspreventiveservicestaskforce.org/.

From: Recommendations for Adults

Cover of The Guide to Clinical Preventive Services 2012
The Guide to Clinical Preventive Services 2012: Recommendations of the U.S. Preventive Services Task Force.

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