Abstract: Objective To study the agreement between ophthalmologists and community health workers in detecting shallow anterior chamber with oblique flashlight test. Methods Totally 425 subjects were given an eye examination in a community health center. The anterior chamber depth of each subject was examined by one ophthalmologist and two trained community health workers (one nurse and one non-professional health worker) using oblique flashlight test. Inter-observer agreement was determined using the weighted kappa statistic. Results Among the enrolled subjects,148 (35%) were male and 277 (65%) were female. Good agreement was noted in all the three observers. The comparison between the ophthalmologist and the nurse showed a kappa statistic of 0.42 for both eyes (P<0.001). The kappa statistic was 0.54 and 0.52 for right and left eyes respectively between the ophthalmologist and the non-professional health worker (P<0.001). As for agreement between the nurse and the non-professional health worker,the kappa statistic was 0.49 and 0.38 for right and left eyes,respectively (P<0.001). Conclusion The oblique flashlight test may be used as an applicable tool by trained community health workers for screening of shallow anterior chamber and play a role in blindness prevention in community.

Key words: glaucoma, shallow anterior chamber, oblique flashlight test

Funding: Supported by Tsinghua-Yue-Yuen Medical Sciences Fund (20240000564) and Norwegian Fredskorpset Exchange Program