ArticleEye (London, England)2025
An education-based intervention investigating the accuracy of community-based optometrists evaluating limbal anterior chamber depth.
Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Evaluation of an education intervention on the number and quality of optometrist narrow-angle referrals.Eye (London, England) · 2026Article
- National UK optometry clinical practice survey: implications for developing glaucoma services in primary care.Eye (London, England) · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn the UK, referrals for suspected primary angle closure (PAC) by community-based optometrists (CBO) to the hospital eye service show moderate accuracy. This study aimed to assess the interobserver agreement of limbal anterior chamber depth (LACD) between CBOs and ophthalmologists and evaluate the impact of an education intervention.
methodsUsing a 7-point LACD grading scale, consultant ophthalmologists graded an LACD image dataset developed from 100 patients attending Moorfields Eye Hospital. Two sets of 84 images were utilised for two LACD online assessments. CBO were recruited and undertook assessments before and after a PAC education package (EP) between August 2023 and January 2024.
resultsFifty-two optometrists completed the initial LACD assessment with a median of 19.0 (IQR 9.3-24.8) years post-registration experience. Using the 7-point LACD grading scale, mean weighted kappa (Kw) for pre-EP was moderate, 0.42 (95% CI, 0.36-0.48), increasing to 0.47 (0.42-0.53) post-EP. Conversion to the 4-point grading scale, Kw was substantial, pre-EP 0.61, (0.56-0.66) and post-EP Kw 0.64 (0.58-0.69). An LACD threshold (<25%) sensitivity and specificity pre-EP was 86.0% (79.9-91.3%) and 84.6 (82.3-86.9), respectively. Post-EP sensitivity decreased to 78.2% (74.1-85.1%) (p = 0.049) but specificity increased to 90.4 (88.1-92.8) (p < 0.001).
conclusionThe 4-point LACD grading scale would be more applicable for a case-finding setting. An accessible EP improved agreement and specificity using the joint Royal College of Ophthalmologists/College of Optometrists PAC referral threshold. This EP may reduce false positive PAC referrals and could be rapidly disseminated to CBO. Further research is needed to assess real-world PAC referrals after an education intervention.
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