USPSTF: Evidence Lacking for Glaucoma Screening in Adults

TUESDAY, May 24, 2022 (HealthDay News) -- The U.S. Preventive Service Task Force (USPSTF) concludes that the evidence is currently insufficient to assess the balance of benefits and harms for screening for glaucoma in asymptomatic adults and for impaired visual acuity in asymptomatic older adults. These findings form the basis of two final recommendation statements published May 24 in the Journal of the American Medical Association.

Roger Chou, M.D., from Oregon Health & Science University in Portland, and colleagues updated the 2013 review on screening for glaucoma to inform the USPSTF. Data were included from 83 studies, with 75,887 participants. Based on one randomized clinical trial, the researchers found that screening of frail elderly persons was not associated with a difference in vision outcomes versus no screening but was associated with significantly greater fall risk. None of the studies examined referral to an eye health professional. Based on these findings, the USPSTF concludes that the evidence is insufficient for assessing the balance of benefits and harms of screening for glaucoma in adults who present in primary care and do not have signs or symptoms of open-angle glaucoma (I statement).

In a second review, Chou and colleagues updated the 2016 review on screening for impaired visual acuity in older adults. Data were included from 25 studies, with 33,586 participants. The researchers found no significant differences in visual acuity or other outcomes for screening versus no screening, based on four trials with 4,819 participants. Treatments are available for many common causes of impaired visual acuity in older adults. Based on these findings, the USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening asymptomatic adults aged 65 years or older who present in primary care without known impaired visual acuity (I statement).

"Regardless of how chronic eye diseases are identified, the need to improve the detection and treatment of these diseases is increasing," write the authors of the second editorial.

Evidence Report 1

Final Recommendation Statement 1

Editorial 1

Evidence Report 2

Final Recommendation Statement 2

Editorial 2