An alternative way to think about glaucoma screening, using a questionnaire as a tool, Chinese version

Rationale, aims and objectives To develop a short screening test for the detection of preclinical glaucoma. Method This case–control study involved 690 participants aged 40 years or older: 338 patients with glaucoma or suspected glaucoma and 352 patients without glaucoma, who served as a control group. All participants were interviewed by a single trained research assistant. Patients' basic demographic and clinical information, past ophthalmic history and responses on the National Eye Institute 25‐item Visual Function Questionnaire were collected. Two glaucoma‐trained ophthalmologists examined all the participants using standard procedures to make a diagnosis. The biostatistical differences between the two groups were determined. Results Five items were selected for glaucoma screening: ‘Sense of worse vision compared with those of the same age’, ‘Ocular pain or discomfort during the past 6 months’, ‘History of cataract’, ‘Family history of glaucoma’ and ‘Hyperopia’. A score of 2 or more was used to define a group of positive cases with the most appropriate values for sensitivity (79.0%), specificity (76.7%) and predictive power (a positive predictive value of 76.5% and a negative predictive value of 79.2%). Conclusion A five‐item instrument was developed to detect preclinical glaucoma. Anyone with a score of 2 or more may need further ophthalmic examination and treatment.