[Glaucoma care in Germany-Results of a survey among German ophthalmologists-Part 1: diagnostics].

Background: Glaucoma care has extended enormously in recent years. We performed a survey among the members of the German Ophthalmological Society (DOG) and the Professional Association of Ophthalmologists in Germany (BVA) to explore treatment patterns, the importance of different diagnostic parameters as well as treatment guidelines in the daily practice of glaucoma care.

Objective: Assessment of the current practice of glaucoma care among German ophthalmologists, evaluation of key diagnostic parameters and their use in daily practice.

Material and methods: Our survey was conducted using an online questionnaire that consisted of 26 questions (107 items) about the treatment practice for the diagnosis and treatment of glaucoma. Complete responses were available from 1361 participants.

Results: Slit-lamp examination still remains the most important tool for diagnosis in glaucoma. A very high ranking was also achieved for optical coherence tomography (OCT) parameters. With respect to clinical interpretation and diagnostic certainty parameters analyzing the optic disc were ranked higher than others. Guideline-oriented care is being practiced by the vast majority of ophthalmologists according to self-reported results-two thirds perform perimetry two or more times and a structural analysis once in the first year after diagnosis. The importance of gonioscopy is controversial among the survey participants and is therefore being practiced with different intensity.

Discussion: The diagnosis of glaucoma is challenging. Different diagnostic parameters are of different values to the ophthalmologists. Morphometric tools have achieved a highly important role for the diagnosis of glaucoma and enable assisted, yet not automated diagnosis. Treatment guidelines and standards are requested and should be implemented in education and care practice.