Separate patients into two groups--those at high risk and those at low risk of ophthalmic disorders
High-risk patients: aged over 65 years, past retinal detachment or serious ocular trauma, persistent visual loss, diabetes, hypertension, sickle cell disease, family history of glaucoma or other heritable ocular disease
Screen high-risk patients every 2 years and schedule exam by ophthalmologist shortly after you identify high-risk factor
Low-risk patients: aged 6 to 40—screen for visual acuity every 3 years and refer only if you find abnormality; aged 40 to 65—screen every 2 years and arrange for eye care provider to monitor for glaucoma and provide optical correction for presbyopia
Don’t do this: screening for glaucoma by performing tonometry best left to eye care providers because they are adept and because tonometry is insensitive to glaucoma; assessment of optic disc cupping is better than tonometry
