title: Interobserver reliability when using the Van Herick method to measure anterior chamber depth.
abstract: BACKGROUND
  The Van Herick method is a quick and easy way to estimate anterior chamber depth, which allows grading of patients according to the likelihood of having primary acute closed-angle glaucoma. However, as the test is highly subjective, measurements and thus grading may vary between observers.
  
  
  OBJECTIVE
  The aim of this study was to investigate the degree of variation of Van Herick scores among observers and to investigate agreement between temporal and nasal scores.
  
  
  METHODS
  A total of 15 observers measured the temporal and nasal Van Herick scores from 18 patients, grouped into cohorts at outpatient glaucoma and corneal clinic. Analysis of data involved assigning a patient to a Van Herick grade based on the median score and then determining the mean standard deviation and percentage consistency for each grade.
  
  
  RESULTS
  We found that Grades 1 and 4 had a high mean percentage consistency (80% and 84.6%, respectively) and a low mean standard deviation (0.45 and 0.26, respectively). Grades 2 and 3 had low mean percentage consistencies (57.5 and 5, respectively) and high mean standard deviations (0.71 and 0.89, respectively). The temporal and nasal scores showed good agreement (κ = 0.61P < 0.001).
  
  
  CONCLUSIONS
  The Van Herick score has a good interobserver reliability for Grades 1 and 4; however, Grades 2 and 3 require further tests such as gonioscopy or ocular coherence tomography. Temporal and nasal scores demonstrated good agreement; therefore, if the nasal score cannot be measured due to nasal bridge size, the temporal can be used as an approximation.
authors.affiliation: Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, DD2 1UB, UK.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Javed
authors.affiliation: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Loutfi
authors.affiliation: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kaye
authors.affiliation: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Batterbury
keywords: Acute closed-angle glaucoma; Van Herick; anterior chamber depth