BMJ 1994;309:1369 (19 November)

Letters

The sight test fee Effectiveness for treatment for glaucoma remains unproved

EDITOR, - D A H Laidlaw and colleagues are concerned that the prevalence of blindness due to glaucoma may increase because of reduced uptake of screening since the introduction of the sight test fee.1 Their implication is that treatment improves outcome. Unfortunately, the effectiveness of treatment for glaucoma remains unproved. Eddy and Billings, in a comprehensive review of the literature, found "not a single book, chapter or paper that systematically reviewed the evidence on the effectiveness of [glaucoma] treatment."2 A 20 year follow up of the outcome of surgery for glaucoma (trabeculectomy) was unable to show field stability irrespective of the intraocular pressure.3 Holmin et al, in a small trial of medical treatment versus no treatment, found no significant difference in field decay between the groups.4 The authors of this study ironically noted, "that a very high pressure tends to impair the circulation and lead to atrophy of the optic . . . [Full text of this article]


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Relevant Article

The sight test fee: effect on ophthalmology referrals and rate of glaucoma detection
D A H Laidlaw, P A Bloom, A O Hughes, J M Sparrow, and V J Marmion
BMJ 1994 309: 634-636. [Abstract] [Full Text]

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