Compliance to Gonioscopy in Patients with Glaucoma Risk Factors: A Clinical Audit from a Tertiary Care Centre
DOI:
https://doi.org/10.55489/njmr.160420261379Keywords:
Gonioscopy, Glaucoma, Clinical Audit, Compliance, Anterior Chamber Angle, Quality ImprovementAbstract
Background: Gonioscopy is the gold standard for anterior chamber angle assessment and is essential for glaucoma screening, diagnosis, and classification. However, it remains underutilized in routine practice, potentially delaying glaucoma diagnosis and treatment. The study aimed to evaluate the proportion of glaucoma suspect patients undergoing gonioscopy for glaucoma screening and diagnosis and to assess the impact of corrective interventions on adherence to gonioscopy examination.
Methods: This prospective observational clinical audit was conducted in the Ophthalmology Outpatient Department of a tertiary care centre over two audit cycles (April-May and August 2025). Adults (>18 years) with glaucoma risk factors were included. Gonioscopy performance and reasons for non-performance were recorded. Between audit cycles, corrective measures comprising staff education, protocol reinforcement, regular reminders, and enhanced patient counselling were implemented. Data were analysed using descriptive statistics and the Chi-square test.
Results: Gonioscopy was performed in 18/85 (21.2%) patients during the first audit cycle and increased to 37/51 (72.5%) following corrective interventions. Clinician-related non-performance decreased from 95.5% to 28.6%. The improvement in gonioscopy adherence between the two audit cycles was statistically significant (χ² = 32.83, p <0.001).
Conclusion: Gonioscopy is underutilized in glaucoma suspects, mainly due to clinician-related factors. Staff training, protocol reinforcement, patient counselling, and periodic clinical audits significantly improve adherence and support early glaucoma diagnosis and treatment.
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Copyright (c) 2026 Rashmi Malhotra, Gurvinder Kaur, Pdiangty Giri Mawlong, Anshu Kapoor
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