Evaluation of Optic Nerve Head Examination in a Resident Based Hospital

To evaluate the accuracy of glaucomatous optic neuropathy diagnosis in a resident based hospital.

Four hundred twenty eyes of 210 patients underwent ocular examination including intra ocular pressure and optic nerve head measurements by third and fourth year residents and suspect cases were referred to a glaucoma specialist for validation. After reevaluation by the specialist a comparison between these two examination results was performed to evaluate the over diagnosis of disease by residents.

In this prospective study, eighteen eyes out of 420 evaluated eyes were diagnosed as either glaucoma suspect (14 eyes) or glaucoma (4 eyes) by residents. After reevaluation by the glaucoma specialist only one eye had suspect optic nerve head which was referred for optic nerve head imaging. All other eyes had normal optic nerve head and retinal nerve fiber layer in examination by the specialist.

The results of the present study indicate a high rate of glaucomatous optic neuropathy over diagnosis by third and fourth year ophthalmology residents. Further studies are needed to find if this over diagnosis is related to poor training or anxiety among residents to miss a real case of glaucoma.