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Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 9-12

Interobserver reliability when using the Van Herick method to measure anterior chamber depth

1 Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, DD2 1UB, UK
2 St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK

Correspondence Address:
Ahmed Javed
The Countess of Chester Hospital, Chester, Cheshire, CH2 1UL, UK
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ojo.OJO_142_2014

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Introduction: 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. Aim: 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. Materials and 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). Conclusion: 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.

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