• IRIS4: Glaucoma – Intraocular Pressure Reduction Following Laser Trabeculoplasty

    Updated January 2018.

    Reporting Options: 

    • IRIS Registry QCDR for EHR: groups and individuals
    • IRIS Registry QCDR manual data entry: groups and individuals

    Measure Type: Outcome

    Description:  Percentage of patients who underwent laser trabeculoplasty who had IOP reduced by 20% or more from their pretreatment.

    To Which Patients Does the Measure Apply?

    Denominator:  Patients aged between 40 and 85 years who underwent laser trabeculoplasty.

    There are two criteria for inclusion of a patient into the denominator.

    1. Patient characteristics: Description located in “Denominator” (see above).
    2. Procedure codes (CPT): Codes located in “CPT Codes.” 

    The quality measure also has exclusions for the denominator.

    CPT Codes

    • Laser trabeculoplasty procedure (CPT: 65855 with modifier RT, LT, -50)


    Report this measure each time you perform a laser trabeculoplasty procedure during the reporting period. The measure is intended to reflect the quality of services provided by the surgeon performing the procedure.

    How to Report the Measure

    Numerator: Eye(s) with a reduction in IOP ≥ 20% from the pretreatment level

    • Numerator calculation: Percent change between pretreatment IOP (do not include IOP values taken on the day of procedure) and the lowest IOP measures between 2 and 4 months postoperatively.
    • Calculation is based on the IOP of the eye that underwent the procedure.

    Denominator Exclusions

    • Eyes with absolute glaucoma blindness (ICD-10: H44.511, H44.512, H44.513, H44.519)
    • Visual acuity findings: Count fingers (CF or FC), hand motion (HM), light perception (LP), no light perception (NLP)


    • No scoring benchmark currently exists for this QCDR measure.
    • If 19 or fewer physicians each report the measure or 20 physicians do not report the measure on at least 60 percent of qualifying patients, and a minimum of 20 patients, you will earn 3 out of 10 points toward your total quality score. Choose measures assuming you’ll only earn 3 points per QCDR measure.
    • If at least 20 physicians report the measure on at least 60 percent of qualifying patients and at least 20 patients, CMS will develop a scoring benchmark using data collected during the 2018 reporting year.


    This measure has been developed by the H. Dunbar Hoskins Jr. MD Center for Quality Eye Care of the American Academy of Ophthalmology. The measure is not a clinical guideline and does not establish a medical standard. It has not been tested in all possible applications.

    The measure, while copyrighted, can be reproduced and distributed with appropriate credit, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. The American Academy of Ophthalmology encourages use of the measure by other health care professionals, where applicable.

    Commercial use is defined as the sale, license or distribution of the measures for commercial gain, or incorporation of some or all of a measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and the American Academy of Ophthalmology. Neither the Academy nor its members shall be responsible for any use of the measures. 


    © 2017 American Academy of Ophthalmology. All rights reserved. Limited proprietary coding from Current Procedural Terminology (CPT®) is contained in the measure specifications. Users of this code set should obtain all necessary licenses. The Academy disclaims all liability for use or accuracy of the coding contained in these measure specifications. CPT® contained in the measures specifications is copyright 2004-2017 American Medical Association.