Gaps in glaucoma care: A systematic review of monoscopic disc photos to screen for glaucoma

One important gap in glaucoma care is the lack of an optimized screening protocol for detecting glaucoma on a population level. A systematic review of the literature was conducted to evaluate the effectiveness of monoscopic disc photos as a screening tool for detecting glaucoma. Six studies met inclusion and exclusion criteria out of 221 possible titles. The specificity of monoscopic photos to detect glaucoma compared to clinical exam was excellent (93.6-100%), while the sensitivity was much lower (50-67.4%). Monoscopic disc photos are highly specific in identifying glaucoma, though additional testing, such as perimetry, may be needed to improve their sensitivity. Further research is needed to evaluate whether monoscopic disc photos are a cost-effective way to screen for glaucoma in a primary care setting utilizing new technological advances in ophthalmic imaging such as portable non-mydriatic fundus cameras.