Glaucoma screening: too little, too late?

Screening for glaucoma, usually by measuring intraocular pressure, has been popular, but repeated analysis indicates poor sensitivity and specificity. More extensive testing is required. Such testing should be focused on high-risk groups, including blacks and the elderly. Regular comprehensive eye examinations, on a schedule adjusted for these and other risk factors, are probably the most cost-efficient means of identifying patients with glaucoma. The primary care provider has a pivotal role: to encourage patients to undergo such examinations when warranted; and to encourage those on intraocular-pressure-lowering medications to comply with their medication use.