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Physician recognition of ophthalmoscopic signs of open-angle glaucoma

Effect of an educational program

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Abstract

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.

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Margolis, K.L., Money, B.E., Kopietz, L.A. et al. Physician recognition of ophthalmoscopic signs of open-angle glaucoma. J Gen Intern Med 4, 296–299 (1989). https://doi.org/10.1007/BF02597400

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