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NEI Statement on the Difference Between Screening and Comprehensive Dilated Eye Exams in Detecting Glaucoma

On July 8, 2013, the U.S. Preventive Services Task Force released its final recommendation statement on screening for open-angle glaucoma. The task force found that there was not enough evidence to determine the accuracy and effectiveness of glaucoma screening in primary care settings for adults who do not have vision problems. Based on this lack of clear evidence, the task force could not make a recommendation for or against screening adults for glaucoma at this time.

"While the task force concluded that there was insufficient evidence to prove that widespread glaucoma screening reduces blindness risk or improves quality of life, this recommendation does not mean that comprehensive dilated eye examinations are not important for preventing vision loss among Americans," said Dr. James Tsai, chair of the Glaucoma Subcommittee for the National Eye Institute's National Eye Health Education Program. Nearly 2 percent of Americans over age 40 (2.7 million in total) have open-angle glaucoma, a leading cause of blindness that has no early warning signs. However, early diagnosis and treatment can prevent vision loss.

Glaucoma screening is a method for assessing an entire population for glaucoma, including those without visual symptoms and those who are not at higher risk for developing glaucoma. In addition, screening usually detects only one risk factor for developing glaucoma: elevated eye pressure. However, because of individual differences in normal eye pressure and the various forms of the disease, this method by itself is not sufficient for an accurate diagnosis of glaucoma.

In contrast, a comprehensive dilated exam looks at the back of the eye to detect subtle changes of the optic nerve in patients without any visual symptoms, thereby potentially leading to early detection of the disease. They are especially recommended every one to two years for people who are at higher risk for glaucoma, including African Americans age 40 and older, everyone over age 60 (especially Mexican Americans), and those with a family history of glaucoma. The task force did find that early treatment for glaucoma is effective in keeping visual field defects from getting worse and this is very important for preserving vision.

For more information on glaucoma, visit: www.nei.nih.gov/health/glaucoma/.

Last Updated: July 2013



Department of Health and Human Services NIH, the National Institutes of Health USA.gov