Long-Term Outcome of Patients Who Undergo Tonometry as Part of a General Physical Examination

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Abstract

Objective

To determine the value of including tonometry as part of a general physical examination.

Material and Methods

Between Feb. 14, 1977, and Dec. 31, 1980, 849 residents of Rochester, Minnesota, underwent measurement of intraocular pressure by trained ophthalmic technicians at the request of a nonophthalmologist physician as part of a general physical examination. In 1995 and 1996, these cases were reviewed to determine how many patients in this study cohort had subsequently been diagnosed as having glaucoma. The outcome was derived from the examination of medical records and from the responses to mailed questionnaires and telephone interviews with study patients and their physicians.

Results

In patients whose intraocular pressures were less than 16 mm Hg at baseline, the risk of being diagnosed as having glaucoma within 10 years was 1% (95% confidence interval [CI], 0 to 2%) and within 15 years was 2% (95% CI, 0 to 4%). In patients whose pressure in the higher-pressure eye was 16 to 21 mm Hg at baseline, the risk of having glaucoma in 10 years was 3% (95% CI, 2 to 5%) and in 15 years was 5% (95% CI, 3 to 7%). Twenty-four patients were found at baseline to have an intraocular pressure of 22 mm Hg or higher in at least one eye or a difference of 5 mm Hg or more between the two eyes. In this group, the risk of having glaucoma in 10 years was 17% (95% CI, 0 to 31%) and in 15 years was 26% (95% CI, 6 to 43%).

Conclusion

When included as part of a general physical examination of older persons, tonometry and a few simple questions provide information that can be used to help the clinician determine the advisability of more detailed ophthalmic examinations.

Mayo Clin Proc 1998;73

309-313

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