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Editors Selection IGR 9-4

Miscellaneous: Online Glaucoma Information: Friend or Foe?

Comment by Paul Healey on:

104873 A Comprehensive Evaluation of the Quality, Readability, and Technical Quality of Online Information on Glaucoma, Shah R; Mahajan J; Oydanich M; Oydanich M et al., Ophthalmology. Glaucoma, 2023; 6: 93-99

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As medical practitioners, ophthalmologists are subjected to rigorous training in how to obtain accurate and useful health information from external sources and how to evaluate that information in terms of quality, validity, applicability, and level of evidence. These skills are less common amongst our patients, raising an important question addressed by this paper: Is the most popular internet-based health information about glaucoma sufficiently accurate and readable to make a useful contribution to a patient's knowledge?

A Google search identified the 150 most visited websites using the terms glaucoma, high intraocular pressure and high eye pressure. Quality was assessed using validated standardized methods and included authorship, attribution, complementarity, justifiability, transparency and currency. Ten metrics were used for readability. The two independent reviewers had high interrater reliability for all but technical quality assessment which was moderate.

The overall readability was at an 11th grade (U.S.) reading level, compared with the American Medical Association recommendation of 6th grade level. The average quality score was only modest, with no website achieving a perfect score.

This simple descriptive study was well executed and provides important information about a relatively little studied area. Its key finding, that the quality of glaucoma informational websites is only modest and written at a level well above many people is in agreement with other, similar studies in glaucoma¹ and dry eye disease.²

The importance to clinical practice is that we should not expect our patients to have an accurate or useful understanding of glaucoma even when they have searched online prior to their appointment with us. It reminds us that our own verbal and written explanations of the disease and its management must use language that is easily understandable to each person to whom we are communicating. Finally, it behooves us to review internet- based, consumer-directed content regarding glaucoma ourselves, so we can feel confident that the website recommendations we may make to our patients will help them better understand their health and its management.

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