Evidence map›Paper›PMID 40110928›Full record

ArticleOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2025

Analysing diagnostic practices and referral pathways for glaucoma in Australian primary eye care.

Catherine L Jan, Randall S Stafford, Xianwen Shang, Jacqueline Henwood, Christian Davey, Jiahao Liu, Peter van Wijngaarden, George Y X Kong, Jennifer C Fan Gaskin, Mingguang He and 1 more

Abstract read
In one paragraph

Article in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Analysing diagnostic practices and referral pathways for glaucoma in Australian primary eye care.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025
    Article
  3. Visual field testing and glaucoma drug prescribing patterns in Australia.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Catherine L JanCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-7383-8208
Randall S StaffordStanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA.
Xianwen ShangCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Jacqueline HenwoodCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Christian DaveySchool of Mathematics and Statistics, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0003-3097-9769
Jiahao LiuCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Peter van WijngaardenCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
George Y X KongCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Jennifer C Fan GaskinCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Mingguang HeCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Algis VingrysCentre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.

Funding

Global STEM Professorship Scheme P0046113Medical Research Future Fund MRFAI00035National Critical Research Infrastructure InitiativeNHMRC Investigator APP1175405Research Training Scholarship from the Australian Commonwealth Government
6 · The paper itself

Abstract

backgroundGlaucoma is the leading cause of irreversible blindness globally, posing a significant public health challenge in Australia, particularly among individuals aged 55 years and older. As primary health care providers, optometrists play a crucial role in the early diagnosis and management of glaucoma, making them central to efforts aimed at reducing the burden of this sight-threatening condition. This study investigates the practice patterns of Australian optometrists in diagnosing and managing glaucoma, focusing on test utilisation, diagnostic confidence, referral practices and intra- and inter-observer variabilities in grading glaucomatous optic neuropathy (GON).

methodsA mixed-method cross-sectional design was conducted, involving 50 Australian optometrists who graded 120 colour digital retinal photographs for GON and completed an online survey regarding their diagnostic methods and confidence levels. Statistical analyses assessed inter- and intra-observer agreement in GON grading.

resultsThe results showed that 82% of optometrists surveyed possessed optical coherence tomography (OCT) instruments and 96% had visual field analysers. Despite a majority expressing confidence in glaucoma detection, only 8% felt capable of independently diagnosing the disease and initiating treatment. Inter-observer agreement for glaucoma detection from retinal photographs was moderate (kappa = 0.53, 95% CI 0.50-0.54), while intra-observer agreement was substantial (kappa = 0.73, 95% CI 0.70-0.77). Inter-observer agreement of optometrists was similar to that of ophthalmologists.

conclusionMost optometrists have access to advanced diagnostic tools, know how to appropriately diagnose and manage glaucoma and have similar inter-observer variability when assessing fundus photographs to that of glaucoma sub-specialists, but few feel confident in independently diagnosing and managing glaucoma.

Indexed as

GlaucomaIntraocular PressureOptometristsOptometryPrimary Health CareReferral and ConsultationAustraliaCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesTomography, Optical CoherenceVisual FieldsAustraliadiagnostic confidenceglaucomaprimary carereferral practices

Identifiers

PMID40110928
PMCPMC12153027

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.