Glaucoma Care and Conformance with Preferred Practice Patterns

Published In: Ophthalmology, v. 103, no. 7, July 1996, p. 1009-1013

Posted on RAND.org on January 01, 1996

by Lars H. Hertzog, Kathleen G. Albrecht, Laurie Labree, Paul Lee

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.

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