Journal of General Internal Medicine

, Volume 4, Issue 4, pp 296–299

Physician recognition of ophthalmoscopic signs of open-angle glaucoma

Effect of an educational program
  • Karen L. Margolis
  • Bruce E. Money
  • Leslie A. Kopietz
  • Eugene C. Rich
Original Articles

DOI: 10.1007/BF02597400

Cite this article as:
Margolis, K.L., Money, B.E., Kopietz, L.A. et al. J Gen Intern Med (1989) 4: 296. doi:10.1007/BF02597400


Objective:To evaluate a short educational intervention instructing primary care physicians in the recognition of glaucomatous changes of the optic disc.

Design:Comparison of performances on a pretest and a posttest consisting of fundus slides in color.

Setting:Educational conferences at two university-affiliated teaching hospitals and one staff-model bealth maintenance organization.

Subjects:Thirty-six internal medicine residents and ten practicing internists.

Intervention:A 20-minute slide/narration educational program, which covered diagnostic criteria for openangle glaucoma, normal and abnormal optic disc anatomy, and funduscopic signs of open-angle glaucoma.

Measurements and main results:Following the intervention, residents showed improved sensitivity (0.76 to 0.88, p=0.007), specificity (0.65 to 0.88, p<0.001), and accuracy (0.71 to 0.88, p<0.001). Internists showed similar increments in sensitivity, specificity, and accuracy: 0.67 to 0.86 (p=0.01), 0.59 to 0.84 (p=0.01), and 0.63 to 0.85 (p=0.002), respectively.

Conclusion:A brief educational intervention can result in meaningful improvement in physician diagnostic accuracy in recognizing ophthalmoscopic signs of open-angle glaucoma.

Key words

open-angle glaucoma ophthalmoscopy screening primary care periodic health examination 

Copyright information

© Society of General Internal Medicine 1989

Authors and Affiliations

  • Karen L. Margolis
    • 1
  • Bruce E. Money
    • 2
  • Leslie A. Kopietz
    • 3
  • Eugene C. Rich
    • 2
  1. 1.Division of General Internal Medicine, Department of MedicineHennepin County Medical CenterMinneapolis
  2. 2.Department of Medicine (BEM, ECR)St. Paul-Ramsey Medical CenterSt. Paul
  3. 3.Department of Ophthalmology (LAK)St. Paul-Ramsey Medical CenterSt. Paul