LONG-TERM OUTCOME OF PATIENTS WHO UNDERGO TONOMETRY AS PART OF A GENERAL PHYSICAL-EXAMINATION

Objective: To determine the value of including tonometry as part of a general physical examination. Material and Methods: Between Feb, 14, 1 977, and Dec, 31, 1980, 849 residents of Rochester, Minnesota, underwe nt measurement of intraocular pressure by trained ophthalmic technicia ns at the request of a nonophthalmologist physician as part of a gener al physical examination. In 1995 and 1996, these cases were reviewed t o determine how many patients in this study cohort had subsequently be en diagnosed as having glaucoma, The outcome was derived from the exam ination of medical records and from the responses to mailed questionna ires and telephone interviews with study patients and their physicians . Results: In patients whose intraocular pressures were less than 16 m m Hg at baseline, the risk of being diagnosed as having glaucoma withi n 10 years was 1% (95% confidence interval [CI], 0 to 2%) and within 1 5 years was 2% (95% CI, 0 to 4%), In patients whose pressure in the hi gher-pressure eye was 16 to 21 mm Hg at baseline, the risk of having g laucoma in 10 Sears was 3% (95% CI, 2 to 5%) and in 15 years was 5% (9 5% CI, 3 to 7%), Twenty-four patients were found at baseline to have a n intraocular pressure of 22 mm Hg or higher in at least one eye or a difference of 5 mm Hg or more between the two eyes, In this group, the risk of having glaucoma in 10 Sears was 17% (95%, CI, 0 to 31%) and i n 15 gears was 26% (95% CI, 6 to 43%). Conclusion: When included as pa rt of a general physical examination of older persons, tonometry and a few simple questions provide information that can be used to help the clinician determine the advisability of more detailed ophthalmic exam inations.