Trouble with screening

The introduction of the recent NICE guidelines for glaucoma referrals has stimulated debate in the profession, but the debate has neglected to look at the bigger picture of how the screening process affects both our patients and the profession as a whole.

Glaucoma fulfils all the criteria for a screening programme1 of regular pressure checks. The condition is common it is serious its progress is understood there is a good screening test and there is good, effective treatment available.

However, various authors have found that screening may do more harm than good.2,3 There are a number of reasons for this, a negative result may reinforce unhealthy lifestyles, give a false sense of invulnerability and even make someone less likely to return for future testing.