This study was aim to obtain the current situation of ophthalmologists following the expert consensus in the diagnosis and treatment of primary glaucoma in China, and evaluate the effect of improving the compliance of expert consensus by live lectures and webcast training.

Cross-section non-random sampling network WeChat questionnaires were used in the survey. From October 2018 to August 2019, questionnaires designed according to the expert consensus of the diagnosis and treatment of primary glaucoma in China were collected from ophthalmologists. The glaucoma expert consensus training was carried out through live lectures, live broadcast and video playback. Two questionnaires were sent through WeChat before and after the training. The differences of consensus awareness and compliance rate were compared the groups who participated in the training or not. Chi-square test was used to compare the counting data between groups, and rank sum test was used to compare the ranking data between groups. Factor analysis was used to analyze the structural validity of the questionnaire, and maximum variance method was used to rotate factors. Kaiser-Meyer-Olkin (KMO) and Bartlett tests.

715 questionnaires were received during the first survey and 515 questionnaires were received during the second survey after the training. The training rate of doctors with senior titles and glaucoma specialists was higher than that of the other ophthalmologists ( χ²=11.541, 59.114; P<0.05). The consensus compliance rates during the first survey were 7.55% to 85.59%, and majority of them were 51.75% to 85.59%. The awareness rates of basic concepts such as normal tension glaucoma (NTG), exclusive diagnosis of ocular hypertension and negative significance of primary angle closure glaucoma (PACG) provocative test were higher (83.36% to 85.59%). The lowest compliance rate was the use of Goldmann tonometer (7.55%), followed by the modified PACG provocative test (14.45% to 28.20%). The correct understanding rate of inferior superior nasal temporal (ISNT) principle for glaucoma optic nerve damage was also low (40.42%). During the second survey after the training, the compliance rate was 17.38% to 82.62% in the group who did not attend the training, besides the overall compliance rate was 20.47% to 96.34% in the group who did. Among them, the compliance rate of those who received training was significantly higher than that of who did not, and the increase was between 11% and 26% with statistical difference in the judgment of the width and narrow grade of gonioscopy, the understanding of glaucoma optic nerve damage and ISNT principle, the interpretation of visual field, the classification of PACG, the definition of NTG, when to treat ocular hypertension, etc(χ²=5.687-31.568, P<0.05).

In current, the compliance of expert consensus on diagnosis and treatment of primary glaucoma in China needs to be improved. Live lectures and wechast training could effectively improve the cognition and compliance of expert consensus. It is necessary to promote the compliance of expert consensus and guidelines in clinical practice through mandatory training and teamwork between glaucoma experts and ophthalmologists.