Patients' perception of glaucoma diagnosis practice: Results from a survey of glaucoma patients in North India.

Abstract

This study assesses the practice patterns of diagnosing ophthalmologists, as reported by glaucoma patients attending specialty glaucoma clinics in urban and rural areas of North India, for a second opinion. Prospective cross-sectional study using a structured interview-based survey was conducted from 1 November 2011 to 31 October 2012 on patients attending two specialty glaucoma care facilities in North India. Both clinics were in North India; however, one was rural (Kaithal) and one was urban (Delhi). Patients were asked through descriptions of machines and processes, regarding practice patterns of their glaucoma diagnosing ophthalmologists. The interview was conducted by ophthalmic assistants in tune with the vernacular of the region, in a language understood by the interviewee. A total of 1506 patients consented to participate in the survey. The majority of patients reported undergoing tests for intraocular pressure measurement; however, 56-60% of these tests were carried out by the non-contact tonometer. More than 90% of patients reported no knowledge regarding the type and severity of the glaucoma they suffered from, and even less reported undergoing gonioscopy (3.6% Karnal and 16% Delhi). 84-86% patients who underwent perimetry reported undergoing at least some digital imaging of the optic disc. Better counselling of, and communication with, the patient would help increase their awareness regarding their condition and the care required. This has the potential to enable better compliance with and adherence to treatment. Standardized training of ophthalmologists to improve clinical diagnosis of glaucoma would also go a long way.