Across two biobanks covering a million adults, more than 68% of recorded glaucoma cases carried no subtype at all. Open-angle and angle-closure glaucoma are different diseases with different mechanisms, different treatments and different urgency — and in the data that inform guidelines and health planning, most cases are simply "glaucoma".
The fix is in your own clinic note. Gonioscopy findings, the angle assessment, the reason you reached the diagnosis you did. Where the picture is genuinely mixed, write that it is mixed rather than leaving the field blank; "unspecified" in a record usually means nobody wrote it down, not that nobody knew.
This matters more in India than in the cohorts studied. Angle-closure is a far larger share of the burden in South and East Asian populations than in European ones, and a record that does not distinguish the two cannot support the screening decisions that difference should drive.
- Write the subtype and the gonioscopy finding that supports it in every glaucoma note
- If the picture is mixed, record it as mixed rather than leaving it unspecified
- Angle-closure is a larger share of the burden in South and East Asian populations
- A coded subtype is what lets a screening programme be designed for the right disease
Why it matters
Two diseases with different mechanisms are being counted as one in the data that shape screening policy.
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