OPTIC DISC INTERPRETATION IN GLAUCOMA - IS CONFIDENCE MISPLACED

A photographic questionnaire has been used to investigate whether or n ot clinicians have realistic expectations of their ability to distingu ish optic discs associated with glaucomatous visual field loss from di scs of healthy eyes. The questionnaire consisting of 30 non-stereoscop ic fundus photographs from 15 patients was administered to 40 ophthalm ologists of varying experience and 10 optometrists. Each group display ed large discrepancies between their expected and achieved scores sugg esting that clinicians may overestimate their ability to recognize the glaucomatous optic disc. This could lead to diagnostic errors especia lly in cases where tonometric and visual field parameters are consider ed equivocal. An over-reliance on the cup/disc ratio appeared to be th e most likely cause of error.