[Preferential screening to prevent glaucoma blindness (author's transl)].

The chief barrier to formulating an effective program of preventing glaucoma blindness is the difficulty of identifying those individuals in the population who have glaucoma but do not know it and those who are likely to develop the disease. Primary open-angle glaucoma (POAG), the most common tupe of glaucomatous disease, is an inherited disease. Fifty percent of all patients who have POAG also have a family history of glaucoma. Further, it is estimated that six to seven percent of the first degree relatives of POAG patients will develop POAG. This information suggests that for ophthalmologists who are likely to have limited time available for glaucoma screening, the most practical glaucoma screening program is that which is directed at those individuals who are first degree relatives of patients known to have glaucoma. For these people, the minimal screening tests should include tonometry, perimetry, and a meticulous examination of the optic discs. If tonometric testing reveals an intraocular pressure of 21-23 mmHg, tonometry should be repeated at different hours of the day. If results of these tests are negative, the patient then should be tested for increased sensitivity to corticosteroids and epinephrine. If all tests are negative, the patient still should be tested periodically. A relationship between HLA antigens and primary open-angle glaucoma has not been confirmed.