Clinical Scorecard: ASCRS 2026: Gonioscopy Still Matters

At a Glance

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

• ASCRS 2026 Presentation by Ramya N. Swamy, MD