Opportunistic Eye Screening Among First-Degree Relatives of Glaucoma Patients at a Suburban Tertiary Center in Malaysia

Radtthiga Chelvaraj; Maya Sapira Hanapi; Siti-Fairuz Mohd-Yusof; Khairy Shamel Sonny Teo; Liza Sharmini Ahmad Tajudin; Azhany Yaakub

doi:10.7759/cureus.25772

Opportunistic Eye Screening Among First-Degree Relatives of Glaucoma Patients at a Suburban Tertiary Center in Malaysia

Cureus. 2022 Jun 8;14(6):e25772. doi: 10.7759/cureus.25772. eCollection 2022 Jun.

Authors

Radtthiga Chelvaraj^{1

2}, Maya Sapira Hanapi^{1

2}, Siti-Fairuz Mohd-Yusof^{1

2}, Khairy Shamel Sonny Teo^{1

2}, Liza Sharmini Ahmad Tajudin^{1

2}, Azhany Yaakub^{1

2}

Affiliations

¹ Department of Ophthalmology and Visual Science, School Of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.
² Ophthalmology Clinic, Hospital USM, Universiti Sains Malaysia, Kubang Kerian, MYS.

Abstract

Background and objective The majority of glaucoma patients are asymptomatic and are usually diagnosed at an advanced stage of the disease. This study aimed to assess the outcomes of glaucoma screening among known first-degree relatives of primary glaucoma patients. Materials and methods This study involved primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG) patients who attended the glaucoma clinic at the Hospital Universiti Sains Malaysia between January 2014 and December 2015. First-degree relatives of the patients underwent a preliminary eye-screening evaluation, including visual acuity (Snellen chart), intraocular pressure (IOP) measurement (air-puff tonometry), and non-mydriatic fundus photography. Patients with visual acuity worse than 6/12, IOP measuring more than 21 mmHg or a difference of more than 3 mmHg between the eyes, and a vertical cup-disc ratio (VCDR) of 0.7 or higher were given a comprehensive eye examination. Results Seventy indexed glaucoma patients were recognized, and 368 first-degree relatives were identified. Forty-five relatives underwent the preliminary screening. Of these, 29 showed normal findings (62%), one had corneal pathology (2%), and 16 (36%) underwent a complete eye examination after failing the initial screening. Among the indexed JOAG group, five relatives (11%) were diagnosed as having JOAG; two were treated medically, while the remaining three required surgical intervention. Conclusion Opportunistic glaucoma screening of high-risk groups, especially JOAG is a feasible and cost-effective way to detect early glaucoma and prevent irreversible blindness. However, improvement in our healthcare system, including the involvement of multicentre clinics in other states in screening initiatives, is required to promote and facilitate the response to screening opportunities.

Keywords: glaucoma; joag; opportunistic screening; pacg; poag.