Abstract:

 Objective To obtain the national real situation of glaucoma dignosis and related instrument usage in China. Design Cross-sectional survey. Participants Ophthalmologists who were internet available throughout the mainland. Method The questionnaire and link were designed and sent by WeChat directly. The respondents filled out the questionnaire directly on the mobile phone, and a mobile phone number can only be submitted once. The data analysis was conducted by SAS 9.4, the association analysis used chi square test. Main Outcome Mearsures Utilization rate of  Goldmann tonometer. The ratio of different instruments used to assess the angle of anterior chamber, fundus, and visual field. The utilization rate of different methods for angle classification. Results A total of 1111 questionnaires were received from 28 provincial administrative regions, among which 20.62% were glaucoma specialists and attending doctors, and 48.48% had glaucoma department in their hospitals. Only 25.29% of them used Goldmann applanation tonometer (GAT) as the routine IOP measurement, and 42.94% didn’t regularely use GAT because of the lack of the device. The most favorite methods in checking chamber angle was gonioscopy (69.49%) , followed by UBM (17.55%). Only 35.64% of the respondents whose frequency of utilization of gonioscopy was between 75%~100%, and 29.26% of the respondents whose frequency of utilization of gonioscopy was less than 25%. Scheie classification was the main (74.17%) grading system for gonioscopy. Direct ophthalmoscope was the most common fundus examination instruments (39.97%), followed by indirect slit-lamp lens (29.16%), and the fundus camera was only 11.61%. 25.74% of those being surveyed had a frequency of utilization of fundus camera less than 25%. In visual field test, Humphrey perimetry (45.00%) was most commonly applied. Glaucoma specialists and attending doctors used gonioscope, fundus cameras and Humphrey perimetry significantly more often than others. Conclusion In the current practice of glaucoma diagnosis in China, GAT measurement has not been widely used. The frequency of utilization of gonioscope and fundus camera was low. There is a gap between real clinical situation and international standards, and the process of training and promotion standalization needs to be strengthened to reduce the difference between China and the international level in glaucoma diagnosis guidelines. (Ophthalmology, 2018, 27: 9-15)

Key words: glaucoma, questionnaires, Goldmann tonometer, gonioscope, fundus camera