Optic disc interpretation in glaucoma: is confidence misplaced?

Abstract
A photographic questionnaire has been used to investigate whether or not clinicians have realistic expectations of their ability to distinguish optic discs associated with glaucomatous visual field loss from discs of healthy eyes. The questionnaire consisting of 30 non-stereoscopic fundus photographs from 15 patients was administered to 40 ophthalmologists of varying experience and 10 optometrists. Each group displayed large discrepancies between their expected and achieved scores suggesting that clinicians may overestimate their ability to recognize the glaucomatous optic disc. This could lead to diagnostic errors especially in cases where tonometric and visual field parameters are considered equivocal. An over-reliance on the cup/disc ratio appeared to be the most likely cause of error.

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