Self-Reported Glaucoma Follow-Up Exam Rates Low

Self-reported glaucoma follow-up adherence is extremely low, according to a recent study published in the Journal of Glaucoma. The findings show a notable drop from both prior studies into the rate of follow-up in patients with glaucoma or suspected glaucoma in the United States, and studies into follow-up glaucoma rates in other high-income countries, researchers report.

“According to the International Council of Ophthalmology (ICO), patients with stable glaucoma should be followed up every 4-12 months, whereas patients with unstable glaucoma should be followed up every 1-4 months,” explain the researchers. “For patients with suspected glaucoma, [clinical tests for monitoring, such as visual field analysis] are essential.”

The researchers used data from the 2015 to 2019 Medical Expenditure Panel Survey

(MEPS) to evaluate adherence to ophthalmic outpatient follow-up visits (according to ICO guidelines) and vision examinations in adults in the US aged 40 years  or older.  

The study assessed the percentage of patients who adhered to glaucoma treatment guidelines and compared individuals with and without self-reported glaucoma who made at least 1 ophthalmic outpatient visit and at least 1 vision examination visit within a year. 

Approximately 4.4 million Americans aged 40 years or older had self-reported glaucoma in 2019, a prevalence rate of 3.21%. The prevalence rate significantly varied according to race (Black, 4.43%; Asian, 3.41%; White, 3.24%; Hispanic, 2.28%; other, 1.52%; P =.01). 

Among these individuals, only 7.1% (95% confidence interval [CI]: 0.05-0.10) and 2.67% (95% CI, 0.014-0.052) underwent 1 or more ophthalmic outpatient examination or vision examination, respectively, per year. 

Factors associated with a higher probability of ophthalmic health care use (ophthalmic outpatient examination or vision examination) included older age, never married status, higher education, eye conditions, and diabetes.

“People with suspected glaucoma should be evaluated in the same manner as patients with confirmed glaucoma, namely through routine examinations such as serial intraocular pressure measurements. Making at least one ophthalmic visit is essential for people with suspected glaucoma,” explain the researchers.

Limitations of the study included potential overestimation of the percentage of patients with perceived glaucoma who adhered to follow-up recommendations due to visits that may not have been for glaucoma follow-up purposes, inability to identify the type of vision examination a patient underwent, inability to weight the data in the regression analysis, inability to identify more factors associated with non-use due to data unavailability, use of self-reported data, and potential reporting bias.