The perimetry ant tonometry in real clinical practice of managing patients with glaucoma: facilities and possibilities

The anonymous survey of 107 ophthalmologists was carried out to assess facilities and practical application of diagnostic equipment in detection and management of glaucoma patients. It is established that main load of dispensary monitoring lies upon out-patient sector (81.8% of interrogated physicians of this level). However, only 12.5% of them have dedicated hours for glaucoma patients as compared to 35.3% of in-patient physicians (p=0.03). This indicates at time deficiency for full-value management of glaucoma patients at the primary care level that may negatively affect quality of dispensary monitoring. The significant deficiency of modern equipment is established. Only 46.4% of institutions are equipped with computerized perimeters. At that, outdated and law informative Förster perimeter remains the only method to assess visual field for 37.4% of specialists. The standard automated perimetry is applied by only 45.4% of physicians, and 9.1% of ophthalmologists in polyclinics apply no perimetry at all. The Maklakov tonometry (78.5%) and pneumotonometry (62.6%) dominate among methods measuring intraocular pressure, while Goldmann tonometry is practically unavailable (2.8%). The study results testify significant gap between Russian clinical practice and international standards requiring comprehensive measures on technical re-equipment and optimization of organization of ophthalmological care.