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)

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.


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


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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NICE Clinical Guidelines, No. 85.
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