The Probability of Glaucoma From Ocular Hypertension Determined by Ophthalmologists in Comparison to a Risk Calculator

OBJECTIVE: To investigate the ability of ophthalmologists to estimate an individual's risk of converting from ocular hypertension to glaucoma, and to compare these estimates to a risk calculator. DESIGN: Cross-Sectional Survey. METHODS: Fifty-one ophthalmologists estimated the probability of developing glaucoma of 4 factitious patients with ocular hypertension, after a didactic review of the Ocular Hypertension Treatment Study (OHTS) results. We compared the physician estimates to the probability estimates of a risk calculator on the basis of the multivariate Cox proportional hazard model of the OHTS results. RESULTS: The average estimates given by the ophthalmologists (mean probability+/-SD) of developing glaucoma in 5 years for patient no. 1, patient no. 2, patient no. 3, and patient no. 4 were 6.5%+/-8.4 (range 1 to 50), 30.6%+/-20.5 (range 1 to 100), 7.1%+/-5.1 (range 0 to 20), and 21.1%+/-17.3 (range 1 to 80), respectively. The risk calculator estimated the probability of glaucoma in these same patients to be 13.7%, 53.8%, 5.1%, and 41.9%, respectively. CONCLUSIONS: The ophthalmologists showed a high range of estimates for the probability of developing glaucoma in the same ocular hypertensive patients. This may lead to either under or over treatment of patients. Clinicians need a more exact method to determine the probability of glaucoma from ocular hypertension.