Strahlman E, Ford D, Whelton P, Sommer A
Dana Center for Preventive Ophthalmology, Wilmer Ophthalmologic Institute, Baltimore, MD.
Arch Intern Med. 1990 Oct;150(10):2159-64.
To determine the effectiveness of vision screening in a primary care setting, we administered a questionnaire and a vision test to 458 patients from a general medical clinic. Subjects were referred for complete ophthalmologic evaluation if they failed the vision test or met other "high-risk" criteria based on information contained in the questionnaire. Patient-initiated requests for eye examinations were also honored. A total of 169 patients were scheduled for eye examinations, and 148 actually underwent ophthalmologic evaluation. One hundred one of those examined were referred on the basis of the study criteria. "Serious eye disease" (cataract, glaucoma, diabetic retinopathy, or age-related macular degeneration) was diagnosed in 96 (95%) of these patients. Prompt surgical intervention was recommended in 27 (27%), and medical treatment was begun in 21 (21%). Of those with serious eye disease, 59% met the criteria by failing the vision test, while 69% met the high-risk criteria determined by the questionnaire. Of the 148 subjects who received ophthalmologic evaluations, 47 requested them. Serious eye disease was diagnosed in 23 (50%) of the 47 patients. None of these individuals required immediate surgery, and medical treatment for glaucoma was begun in eight (17%). These data suggest that screening for serious eye disease in a primary care setting is an efficient mechanism to use for the identification of patients with undetected ocular disorders that require follow-up or treatment.
为了确定在初级保健机构中视力筛查的有效性，我们对一家普通内科诊所的458名患者进行了问卷调查和视力测试。如果患者视力测试未通过或根据问卷中的信息符合其他“高危”标准，则会被转介进行全面的眼科评估。患者主动提出的眼部检查请求也会得到满足。共有169名患者被安排进行眼部检查，其中148名实际接受了眼科评估。在接受检查的患者中，有101名是根据研究标准被转介的。在这些患者中，96名（95%）被诊断患有“严重眼病”（白内障、青光眼、糖尿病视网膜病变或年龄相关性黄斑变性）。27名（27%）患者被建议立即进行手术干预，21名（21%）患者开始接受药物治疗。在患有严重眼病的患者中，59%是因为视力测试未通过而符合标准，而69%是根据问卷确定的高危标准符合标准。在接受眼科评估的148名受试者中，有47名是主动要求的。在这47名患者中，23名（50%）被诊断患有严重眼病。这些患者中没有人需要立即手术，8名（17%）患者开始接受青光眼药物治疗。这些数据表明，在初级保健机构中筛查严重眼病是一种有效的机制，可用于识别需要随访或治疗的未被发现的眼部疾病患者。
