Glaucoma screening with oculokinetic perimetry in general practice: is its specificity acceptable?

The main aim of the study was to estimate the specificity of oculokinetic perimetry (OKP) for glaucoma case-finding in general practice. The visual fields of 185 consecutive patients aged 40 years or more were screened with OKP in one general practice. Test specificity was 94%. The OKP test was abnormal in 17 patients. At follow-up 6 of these patients had glaucoma or were glaucoma suspects. Three of the remaining 11 patients had cataract. Eight OKP-positive patients had no eye disease. In 96 of the patients results of OKP were compared with Bjerrum campimetry, which revealed one possibly false-negative OKP test. Ten patients with previously diagnosed glaucoma were also examined with OKP. All 10 patients were identified by the OKP test. In 80 of the patients OKP was performed twice, supervised by two different observers. The proportion of agreement for normal tests was very high : 0.96 (95% CI : 0.91-1.0). The proportion of agreement for abnormal tests was 0.79 (95% CI : 0.57-1.0). The OKP test may be useful in glaucoma case-finding in general practice. However, the proportion of false-positive tests seems to be too high for OKP to be used alone in mass screening.