Open-angle glaucoma: To screen or not to screen?
In a published statement in JAMA Network on May 24/31, 2022, the U.S. Preventive Services Task Force found that there was insufficient evidence for screening for primary open-angle glaucoma in adults. They could not find a way to balance harms versus benefits for screening in general. But is this reasoning faulty?
It is well known that Black and Hispanic populations suffer a greater incidence and severity of glaucoma, and these populations deserve screening. The Task Force suggests that demographics for glaucoma damage result from disparities in access to the health care system, rather than from genetic predisposition. The Task Force concludes that although there are useful diagnostic tests to determine glaucoma, tests are not beneficial for screening purposes. In the official statement, screening results in more harm from over-treatment, such as cataract formation from glaucoma surgery and eye irritation from medications.