Table 4-14Van Herick’s test vs. gonioscopic methods - Clinical study characteristics

OutcomeNumber of studiesDesignLimitationsInconsistencyDirectnessOther considerations
Diagnostic accuracy at cut- off ≤ 25% corneal thickness 9,1492Diagnostic studySerious limitations (a)No serious inconsistencySerious indirectness (b)(c)
a

Both studies are in a consecutively selected cohort of patients. In one study9 it is not clear whether Van Herick’s test was performed independently, within a reasonable time frame and in a masked fashion to gonioscopy. Both studies reported full test results for all patients.

b

Both studies are in patients from south-east Asia and the Indian sub-continent where the prevalence of closed-angles tends to be higher.

c

For gonioscopy there are variations between studies in type of gonioscopy lens and grading system used for classification of narrow angles. For Van Herick’s test one study9 uses a modified cut-off grade for of ≤ 25% of corneal thickness as indicative of narrow angles whereas the other study149 uses grade 1 <25% corneal thickness as indicative of narrow angles.

From: 4, Diagnosis of patients with ocular hypertension, chronic open angle glaucoma and suspected chronic open angle glaucoma

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Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension.
NICE Clinical Guidelines, No. 85.
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