[Usefulness of a glaucoma and ocular hypertension screening strategy in primary care]. / Utilidad de una estrategia de cribado de hipertensión ocular y glaucoma en atención primaria.

OBJECTIVES: To evaluate the usefulness of a glaucoma and intraocular hypertension screening strategy for new cases detected. To evaluate the acceptability of taking intra-ocular pressure (IOP) and the appearance of side effects. DESIGN: Cross-sectional, descriptive study. SETTING: An urban health centre and the ophthalmology clinic of its main hospital. PARTICIPANTS: A total of 2044 patients aged over 40, 63.5% women and 36.5% men, with a mean age of 61.23 (SD, 11.42). They were selected by consecutive sampling from patients who visited the health centre over a 9-month period. Subjects diagnosed with glaucoma, ocular hypertension (OH), conjunctivitis, or corneal pathology were excluded. INTERVENTIONS: Taking of IOP with Tonopen XL in primary care. Subjects with IOP > or = 21 mm Hg were referred to ophthalmology. In these patients, IOP was measured with Goldmann, and patients with confirmed OH received ophthalmoscopy and campimetry. MAIN MEASUREMENTS: Percentage of subjects with glaucoma, suspected glaucoma, and OH confirmed in ophthalmology. Positive predictive value (PPV) for OH. RESULTS: One hundred subjects with OH were detected (4.89%; 95% CI, 3.93%-5.85%), of whom 21 were diagnosed with glaucoma (1.04%; 95% CI, 0.57-1.49) and 10 with suspected glaucoma (0.49%; 95% CI, 0.16-0.82). The PPV for OH was 44.27%. The acceptability of the test was 98.09%. No patients presented with side-effects following the taking of their IOP. CONCLUSIONS: The strategy evaluated is useful in terms of the number of subjects with glaucoma and OH detected. The acceptability of taking IOP with Tonopen XL was high.

Utilidad de una estrategia de cribado de hipertensión ocular y glaucoma en atención primaria / Usefulness of a glaucoma and ocular hypertension screening strategy in primary care

Objetivos. Evaluar la utilidad de una estrategia de cribado de glaucoma e hipertensión ocular (HTO) medida como número de casos detectados. Evaluar la aceptabilidad de la toma de presión intraocular (PIO) y la aparición de efectos secundarios. Diseño. Estudio descriptivo transversal. Emplazamiento. Centro de salud urbano y consulta de oftalmología del hospital de referencia. Participantes. En total, 2.044 pacientes mayores de 40 años, seleccionados por muestreo consecutivo entre los que consultaron en el centro de salud durante 9 meses. Se excluyeron los sujetos diagnosticados de glaucoma, HTO, conjuntivitis o enfermedad corneal. Intervenciones. Toma de PIO con Tonopen XL en atención primaria. Se remitió a oftalmología a los sujetos con una PIO ≥ 21 mmHg. En éstos se midió la PIO con la prueba de Goldmann y, en los que se confirmó la HTO, se realizaron una oftalmoscopia y una campimetría. Mediciones principales. Porcentaje de sujetos con glaucoma, sospecha de glaucoma e HTO confirmada en oftalmología. Valor predictivo positivo (VPP) para HTO. Resultados. Se detectaron 100 sujetos con HTO (4,89%; intervalo de confianza [IC] del 95%, 3,93-5,85%), de los que 21 fueron diagnosticados de glaucoma (1,04%; IC del 95%, 0,57-1,49%) y 10 de sospecha de glaucoma (0,49%; IC del 95%, 0,16-0,82). El VPP para HTO fue del 44,27%. La aceptabilidad de la prueba fue del 98,09%. Ningún paciente presentó efectos secundarios tras la toma de la PIO. Conclusiones. La estrategia evaluada es útil en cuanto al porcentaje de sujetos con glaucoma e HTO detectados. La aceptabilidad de la toma de la PIO con Tonopen XL es alta

Objectives. To evaluate the usefulness of a glaucoma and intraocular hypertension screening strategy for new cases detected. To evaluate the acceptability of taking intra-ocular pressure (IOP) and the appearance of side effects. Design. Cross-sectional, descriptive study. Setting. An urban health centre and the ophthalmology clinic of its main hospital. Participants. A total of 2044 patients aged over 40, 63.5% women and 36.5% men, with a mean age of 61.23 (SD, 11.42). They were selected by consecutive sampling from patients who visited the health centre over a 9-month period. Subjects diagnosed with glaucoma, ocular hypertension (OH), conjunctivitis, or corneal pathology were excluded. Interventions. Taking of IOP with Tonopen XL in primary care. Subjects with IOP 21 mm Hg were referred to ophthalmology. In these patients, IOP was measured with Goldmann, and patients with confirmed OH received ophthalmoscopy and campimetry. Main measurements. Percentage of subjects with glaucoma, suspected glaucoma, and OH confirmed in ophthalmology. Positive predictive value (PPV) for OH. Results. One hundred subjects with OH were detected (4.89%; 95% CI, 3.93%-5.85%), of whom 21 were diagnosed with glaucoma (1.04%; 95% CI, 0.57-1.49) and 10 with suspected glaucoma (0.49%; 95% CI, 0.16-0.82). The PPV for OH was 44.27%. The acceptability of the test was 98.09%. No patients presented with side-effects following the taking of their IOP. Conclusions. The strategy evaluated is useful in terms of the number of subjects with glaucoma and OH detected. The acceptability of taking IOP with Tonopen XL was high