Ophthalmic care – Reaching out to the ageing population. Experiences in Sweden

Purpose To evaluate the suitability of a web‐based inter‐professional system for large‐scale screening for age‐related eye diseases in elderly people Methods Current diagnostic devices, i.e. automatic perimeters and non‐mydriatic fundus cameras were installed in ~90 optician’s shops, and connected to a server. Visual acuity, refraction and intra‐ocular pressure were measured and entered into the system, together with general health history and family history of eye diseases. These data sets from 30 511 screening procedures in 24 002 customers in optician´s shops were evaluated by experienced ophthalmologists (n = 9), who produced a statement to the customer or, when needed, a recommendation of follow‐up visit or a referral note to conventional eye care. Results ICD‐10 codes were recorded in 27 148 examinations. The most common code (56%) was Z01.0 Examination of eye and vision (n=15 079). Second most common diagnosis (21%) was Z71.1, i.e. suspected disease, but no diagnosis confirmed (n= 5 724). More than every fifth patient (n= 5 509 subjects) have undergone repeated screening(s). 1 760 subjects (6.5%) were referred to conventional eye care. The most common codes among these were H3, chorioidal and retinal diseases (n=643) and H4, glaucoma (n=208). A survey was performed of 123 randomly selected referral responses. In 121 cases the subjects had been recommended treatment or follow‐up at the clinic. Conclusion The screening system, with examinations performed in optician’s shops and findings evaluated by ophthalmologists, detected the expected proportion of age‐related diseases with high sensitivity. The system appears to be suitable for large‐scale screening of elderly people.