ASCRS 2026: Gonioscopy Still Matters
At the ASCRS Subspecialty Day, Ramya Swamy, MD explained that, despite advances in imaging, direct visualization of the angle remains central to care
Clinical Scorecard: ASCRS 2026: Gonioscopy Still Matters
At a Glance
Category Detail
Condition Glaucoma Key Mechanisms Direct visualization of the iridocorneal angle. Target Population Patients with glaucoma, particularly those undergoing surgery. Care Setting Glaucoma clinics.
Key Highlights
Gonioscopy is essential for direct assessment of angle structures. Only 49% of Medicare patients had documented gonioscopy prior to surgery. Over 70% of patients lack documented gonioscopy within the first 6 months of evaluation. Imaging modalities like OCT and UBM are complementary but not substitutes for gonioscopy. Handheld imaging devices can enhance gonioscopy but have limitations. Guideline-Based Recommendations
Diagnosis
Perform gonioscopy to assess the iridocorneal angle. Management
Use gonioscopy for procedural planning and identification of secondary pathology. Monitoring & Follow-up
Document gonioscopy findings consistently in patient records. Risks
Inconsistent performance and documentation of gonioscopy may lead to inadequate patient assessment. Patient & Prescribing Data
Patients with glaucoma requiring angle assessment.
Gonioscopy remains critical despite advancements in imaging technology.
Clinical Best Practices
Ensure gonioscopy is performed and documented in all glaucoma evaluations. Utilize adjunctive imaging technologies to supplement gonioscopy findings. Train staff to improve proficiency in performing gonioscopy. References
