A Survey of Current Gonioscopy Practice in the United Kingdom

This survey highlights a deficiency in gonioscopy practices across the UK, particularly in the utilization of indentation gonioscopy and training of junior ophthalmologists. Recommendations include standardizing practice and enhancing training opportunities to improve patient care.

Gonioscopy is an important general skill learned and practiced by all grades of ophthalmologists. The aim of this study is to discover the general attitude, perception, and practice of gonioscopy among ophthalmologists in the UK.

A National gonioscopy survey was carried out by utilizing an anonymous electronic questionnaire of 18 questions. The questionnaire was electronically distributed online, using the survey tool, Microsoft 2016 "MS Forms" to all grades of ophthalmologists in the UK.

A total of 146 responses were analyzed. Overall, 89% of the participants felt "comfortable in performing slit lamp gonioscopy," but only 38% of junior trainees (ophthalmic specialist trainees years 1-3) felt comfortable in gonioscopy. Only 13% of the junior trainees felt they had adequate training in performing gonioscopy compared with 68% of the total respondents. Surprisingly, the majority of consultants (58%) did not "strongly agree" to be confident in assessing the angle and its configuration on gonioscopy. The most commonly used gonioscopic lens in this survey was the Zeiss four-mirror gonio lens, but only 38% of participants performed indentation gonioscopy routinely. The majority of the participants utilized the modified Shaffer's classification for gonioscopy. Fewer than expected numbers performed gonioscopy routinely for new patients with glaucoma.

This survey suggests that gonioscopy is not being performed according to the UK national recommendations, and few ophthalmologists perform indentation gonioscopy. Additional gonioscopy training in the curriculum may be helpful.