Glaucoma Care and Conformance with Preferred Practice Patterns

The authors look at glaucoma care in conformance with preferred practice patterns, and address the question of conformance within the private community-based setting of health care. Based on an examination of 193 charts from 8 different practices of patients who received diagnoses for at least 2 years of open-angle glaucoma, they compare the care received to recommendations from the American Academy of Ophthalmology's preferred practice pattern for primary open-angle glaucoma. Chart examinations from private community-based ophthalmologists showed that some initial examinations such as gonioscopy and pupil examination are performed to widely varying degrees and patients are likely to be scheduled for follow-up within guideline-recommended intervals. However, patients with unstable glaucoma are the least likely to be so scheduled. In addition, the visual appearance of the optic nerve is recorded for a relatively low percentage of the patients. The authors conclude that compliance with these guidelines could be improved.