The European Glaucoma Society Glaucocard project: improved digital documentation of medical data for glaucoma patients based on standardized structured international datasets

  • Marc Schargus
  • Franz Grehn
  • The Glaucocard Workgroup



To evaluate existing international IT-based ophthalmological medical data projects, and to define a glaucoma data set based on existing international standards of medical and ophthalmological documentation. To develop the technical environment for easy data mining and data exchange in different countries in Europe.


Existing clinical and IT-based projects for documentation of medical data in general medicine and ophthalmology were analyzed to create new data sets for medical documentation in glaucoma patients. Different types of data transfer methods were evaluated to find the best method of data exchange between ophthalmologists in different European countries.


Data sets from existing IT projects showed a wide variability in specifications, use of codes, terms and graphical data (perimetry, optic nerve analysis etc.) in glaucoma patients. New standardized digital datasets for glaucoma patients were defined, based on existing standards, which can be used by general ophthalmologists for follow-up examinations and for glaucoma specialists to perform teleconsultation, also across country borders. Datasets are available in different languages. Different types of data exchange methods using secure medical data transfer by internet, USB stick and smartcard were tested for different countries with regard to legal acceptance, practicability and technical realization (e.g. compatibility with EMR systems).


By creating new standardized glaucoma specific cross-national datasets, it is now possible to develop an electronic glaucoma patient record system for data storage and transfer based on internet, smartcard or USB stick. The digital data can be used for referrals and for teleconsultation of glaucoma specialists in order to optimize glaucoma treatment. This should lead to an increase of quality in glaucoma care, and prevent expenses in health care costs by unnecessary repeated examinations.


Glaucoma Medical records systems Computerized Data base 



The Glaucocard Study group received an unrestricted grant from MSD/Chibret Europe

The Glaucocard Workgroup consists of:

A Anton, Universidad Autonoma de Barcelona, Spain;

F Dannheim, Seevetal, Germany;

F Grehn, University Eye Hospital, Würzburg, Germany;

R Hitchings, Moorfields Eye Hospital, London, UK;

AH Hommer, Sanatorium Hera, Vienna, Austria;

M Hyppa, Karlsruhe, Germany;

M Schargus, University Eye Hospital, Würzburg, Germany;

CE Traverso Clinica Oculistica, DiNOG, Azienda Ospedale Universita` San Martino, Genoa, Italy;

R Waedlich, ifa systems AG, Frechen, Germany;

S Wente, ASW GmbH Fidus, Darmstadt, Germany;

T Zeyen, University Eye Hospital Leuven, Belgium


  1. 1.
    Michelson G, Groh MJ (2001) Screening models for glaucoma. Curr Opin Ophthalmol 12:105–111PubMedCrossRefGoogle Scholar
  2. 2.
    Traverso CE, Walt JG, Kelly SP et al (2005) Direct costs of glaucoma and severity of the disease: a multinational long term study of resource utilisation in Europe. Br J Ophthalmol 89:1245–1249PubMedCrossRefGoogle Scholar
  3. 3.
    Hitzl W, Hornykewycz K, Grabner G et al (2007) On the relationship between age and prevalence and/or incidence of primary open-angle glaucoma in the “Salzburg-Moorfields Collaborative Glaucoma Study”. Klin Mon Bl Augenheilkd 224:115–119CrossRefGoogle Scholar
  4. 4.
    Quigley HA, Broman AT (2006) The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 90:262–267PubMedCrossRefGoogle Scholar
  5. 5.
    Internal market analysis of ifa systems AG. Available through:
  6. 6.
    Dietlein TS, Jordan J, Dinslage S et al (2005) Patient characteristics in a tertiary glaucoma center. Circumstances of treatment and attitudes of patients. Ophthalmologe 102:502–506PubMedCrossRefGoogle Scholar
  7. 7.
    Glaukom Ausweis. Available at
  8. 8.
    Mertz M (1999) ByOPHTEL: a Bavarian project for rapid telemedical exchange of knowledge, files and skills between practitioners and hospitals in eye care. Stud Health Technol Inform 64:164–172PubMedGoogle Scholar
  9. 9.
    Mertz M, Mann G, Zahlmann G et al (1997) Scientific role of German ophthalmology in the European telecommunication project OPHTEL. Ophthalmologe 94:523–528PubMedCrossRefGoogle Scholar
  10. 10.
    Engelbrecht R, Hildebrand C (1997) DIABCARD: a smartcard for patients with chronic diseases. Clin Perform Qual Health Care 5:67–70PubMedGoogle Scholar
  11. 11.
    Engelbrecht R, Hildebrand C (1999) Telemedicine and diabetes. Stud Health Technol Inform 64:142–154PubMedGoogle Scholar
  12. 12.
    Engelbrecht R, Hildebrand C, Brugues E et al (1996) DIABCARD–an application of a portable medical record for persons with diabetes. Med Inform (London) 21:273–282Google Scholar
  13. 13.
    Do Once and Share Glaucoma: DOAS Glaucoma Clinical Care Pathway & Dataset – June 2006 v1.0. 2007. Available at:
  14. 14.
    Health Level 7 Homepage. Available at:
  15. 15.
    XML Core Working Group Public Page. Available at:
  16. 16.
    DICOM: Digital Imaging and Communications in Medicine. Available at:
  17. 17.
    WHO (2005) International classification of diseases and related health problems, 10th Revision. WHO, GenevaGoogle Scholar
  18. 18.
    Biermann H (1995) ICD & ICPM in der Augenarztpraxis. Biermann Verlag, ZuelpichGoogle Scholar
  19. 19.
    DIMDI (2006) ICD-10-GM 2007, Systematisches Verzeichnis, 10. Revision - German Modification. Deutscher Ärzteverlag, BerlinGoogle Scholar
  20. 20.
    International Health Terminology Standards Development Organisation (IHTSDO): SNOMED CT. Available at:
  21. 21.
    European Glaucoma Society (2003) Terminology and guidelines for glaucoma. Dogma Srl, SavonaGoogle Scholar
  22. 22.
    National Centre for Classification in Health: Condensed Classification of Health Interventions (CCHI). Available at:
  23. 23.
    WHO (1978) International Classification of Procedures in Medicine (ICPM). WHO, Geneva, SwitzerlandGoogle Scholar
  24. 24.
    Graubner B (2006) OPS 2007 2 Bände: Systematisches Verzeichnis mit Erweiterungskatalog, Operationen und Prozedurenschlüssel - Internationale Klassifikation der Prozeduren in der Medizin. Deutscher Ärzteverlag, BerlinGoogle Scholar
  25. 25.
    Agence Technique de l’Information sur l’Hospitalisation: Kit de nomenclature CCAM V10. 2007. Available at:
  26. 26.
    Nordic Medico-Statistical Committee (NOMESCO) (2005) NOMESCO Classification of Surgical Procedures (NCSP), version 1.10. Tryk & Design a-s, CopenhagenGoogle Scholar
  27. 27.
    Logical Observation Identifiers Names and Codes (LOINC). Available at:
  28. 28.
    Medisoft Ophthalmology. Available through: http://www.
  29. 29.
    ifa systems. Available through:
  30. 30.
    European Glaucoma Society. Available at:

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Marc Schargus
    • 1
  • Franz Grehn
    • 1
  • The Glaucocard Workgroup
    • 2
  1. 1.Department of OphthalmologyUniversity of WürzburgWürzburgGermany
  2. 2.University Eye Hospital WürzburgWürzburgGermany

Personalised recommendations