National survey of ophthalmologists in Singapore for the assessment and management of asymptomatic angle closure.
OBJECTIVE
Approximately 10% of Chinese people older than 50 years in Singapore have asymptomatic narrow angles [also termed primary angle closure suspects (PACS)]. The aim of this study was to determine the attitudes and practices of ophthalmologists in Singapore regarding the management of these patients.


METHODS
A nation wide questionnaire-based survey was conducted on all registered, practicing ophthalmologists in Singapore by electronic mail and post. An ophthalmologist was defined as a doctor who had completed at least 3 years of specialist training in ophthalmology and had passed the Master's Degree in Ophthalmology or equivalent examinations. The survey asked the ophthalmologists about the methods and criteria used for the diagnosis of angle closure. It also inquired about the management of PACS and opinions on the effectiveness of prophylactic laser peripheral iridotomy (LPI) in preventing both acute and chronic angle closure.


RESULTS
A total of 126 out of 158 ophthalmologists responded (79.7% response rate). Of the respondents, 84.9% would advise prophylactic LPI for asymptomatic PACS; 84.9% believed that prophylactic LPI would prevent acute angle closure but only 44% thought that it could prevent the development of glaucomatous optic nerve damage. The preferred method of prophylactic LPI was sequential argon-YAG LPI. In assessing patients for angle closure, 85.4% used gonioscopy, 92.9% assessed anterior chamber depth, and 17.5% performed provocative tests.


CONCLUSIONS
Ophthalmologists in Singapore vary in the method of assessment of patients with angle closure. Most believe that prophylactic LPI should be performed for asymptomatic PACS.
Ang
Marcus H N
MH
Singapore National Eye Centre, Singapore Eye Research Institute, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Baskaran
Mani
M
Kumar
Rajesh S
RS
Chew
Paul T K
PT
Oen
Francis T S
FT
Wong
Hon-Tym
HT
Jap
Aliza
A
Au Eong
Kah-Guan
KG
Seah
Steve K L
SK
Aung
Tin
T
D044466:Asian People / Q000208:ethnology; D001766:Blindness / Q000517:prevention & control; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D006068:Gonioscopy; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007429:Intraocular Pressure; D007498:Iris / Q000601:surgery; D053685:Laser Therapy; D009313:National Health Programs; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome