What Glaucoma Patients Are Reading on the Internet: A Systematic Analysis of Online Glaucoma Content.

PURPOSE: To systematically assess the content, quality, accuracy, navigability, and readability of the highest ranked online information regarding glaucoma. DESIGN: Internet-based, cross-sectional study. PARTICIPANTS: Not applicable. METHODS: The top 15 Google websites that resulted from the search term "glaucoma" were independently evaluated by 3 glaucoma specialists for content, accuracy (1-4 scale), and navigability (1-3 scale) in March 2020. Content was evaluated by answers to 25 questions regarding information most relevant to glaucoma patients (0-2 scale). Readability (Flesch-Kincaid grade level) and quality (Quality Component Scoring System) were also analyzed. MAIN OUTCOME MEASURES: Overall content, accuracy, navigability, quality component scores, and reading grade level as described. Additional analyses included type of websites, presence and type of graphic content. RESULTS: The mean (standard deviation) content score for all websites was 28 (7.6) of 50 possible points (range, 15-45). Inter-rater reliability for content score was good (0.619, 0.746, 0.872 for 3 pairwise comparisons between graders). Mean accuracy score was 9.8 (2.2) of 12 possible points (range, 5-12). Mean navigability score was 7.5 (1.4) of 9 possible points (range, 5-9). Mean reading grade level was 9.3 (1.7) with a range of 7-13 reading grades. Mean quality component score was 7.7 (2.6) of 13 possible points (range, 3-11). Six websites (40%) attempted to visually simulate glaucoma symptoms as tunnel vision (n = 5) and black spots (n = 1). Google rank did not correlate with any of the measures. CONCLUSIONS: The most readily accessible online information about glaucoma varies in content, quality, accuracy, navigability, and readability. This systematic analysis identifies potential areas of improvement.

Gender Compensation Gap for Ophthalmologists in the First Year of Clinical Practice.

PURPOSE: To identify the role of gender and other factors in influencing ophthalmologists' compensation. DESIGN: Cross-sectional study. PARTICIPANTS: U.S. practicing ophthalmologists. METHODS: Between January and March 2020, an anonymous survey was sent to U.S. residency program directors and practicing ophthalmologists who recently completed residency training. Respondents who completed residency ≤ 10 years ago and responded to questions about gender, fellowship training, state of practice, and salary were included. Propensity score match (PSM) analysis was performed with age, academic residency, top residency, fellowship, state median wage, practice type, ethnicity, and number of workdays. Multivariate linear regression (MLR) analysis controlled for additional factors along with the aforementioned variables. MAIN OUTCOME MEASURES: Base starting salary with bonus (SWB) received in the first year of clinical position was the main outcome measure. A multiplier of 1.2 (20%) was added to the base salary to account for bonus. RESULTS: Of 684 respondents, 384 (56% were female, 44% were male) from 68 programs were included. Female ophthalmologists received a mean initial SWB that was $33 139.80 less than that of their male colleagues (12.5%, P = 0.00). The PSM analysis showed an SWB difference of -$27 273.89 (10.3% gap, P = 0.0015). Additionally, SWB differences were calculated with the number of workdays substituted by operating room (OR) days (-$27 793.67 [10.5% gap, P = 0.0013]) and clinic days (-$23 597.57 [8.90% gap, P = 0.0064]) in separate PSM analyses. The SWB differences between genders were significant using MLR analyses, which also controlled for work, clinic, and OR days separately (-$22 261.49, $-18 604.65, and $-16 191.26, respectively; P = 0.017, P = 0.015, P = 0.002, respectively). Gender independently predicted income in all 3 analyses (P < 0.05). Although an association between gender and the attempt to negotiate was not detected, a greater portion of men subjectively reported success in negotiation (P = 0.03). CONCLUSIONS: Female ophthalmologists earn significantly less than their male colleagues in the first year of clinical practice. Salary differences persist after controlling for demographic, educational, and practice type variables with MLR and PSM analyses. These income differences may lead to a substantial loss of accumulated earnings over an individual's career.

Marijuana and Glaucoma: A Social Media Content Analysis.

PURPOSE: This study analyzes the content quality and characteristics of the most popular and highly ranked search results on the internet related to glaucoma and medical cannabis (MC). DESIGN: Internet-based, cross-sectional study. PARTICIPANTS: Not applicable. METHODS: Google and 2 social media platforms (Facebook, YouTube) were used to identify online information most accessible to patients. Search criteria included "glaucoma" AND "marijuana" or "cannabinoid" or "CBD." The top 20 Google search and YouTube results for each search term and the posts from the top 9 patient-based glaucoma Facebook groups were aggregated and analyzed using the search criteria. MAIN OUTCOME MEASURES: The quality of the content was graded by 2 independent graders using a previously validated Sandvik score and previously reported risk score. The differing values were resolved by a final grader. Additional analysis included whether the source was professional (by physician or medical organization) or shared an opinion on MC (pro, mixed, or against) use in glaucoma. RESULTS: This search resulted in an aggregate of 51 websites on Google, 126 posts from Facebook groups, and 37 videos on YouTube. The mean (± standard deviation) Sandvik score and risk score were 11.0 (±2.23), 10.2 (±1.12), 10.6 (±1.89) and 0.27 (±0.49), 0.46 (±0.62), 0.97 (±0.90) for Google, Facebook, and YouTube, respectively. Analysis of variance showed statistically significant differences in Sandvik (P = 0.01) and risk (P < 0.0001) scores across the 3 platforms. A significant portion of online material was pro-MC use in the setting of glaucoma (24% of Google, 59% of YouTube, and 21% of Facebook results). Professional content had a significantly higher content quality score and a lower risk score, and was less likely to recommend MC use in glaucoma. CONCLUSIONS: Despite American Academy of Ophthalmology, Canadian Ophthalmological Society, and American Glaucoma Society statements against MC use in patients with glaucoma, a significant portion of online material recommends its use. With the wide variation in quality and content of online information, it is important for physicians to be aware of the different platforms and opinions that are readily available to patients.