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During your glaucoma evaluation, our doctors will do a thorough analysis of your optic nerve anatomy and function. A dilated eye exam is performed providing direct visualization of your optic nerve. Specialized testing is also performed including: intraocular pressure (called IOP) measured, Visual field testing, Retina and Optic Nerve tissue analysis (called Optical Coherence Tomography) and ocular drainage system visualization (called Gonioscopy).
Optic Nerve Visualization
The optic nerve is an “electrical” connection between the eyeball and the brain. It exits through the back of the eye. In healthy eyes, the optic nerve head looks much like a doughnut, with the outer ring consisting of the nerve tissue. The hole (called the optic cup) is the empty space within the central nerve head. In glaucoma, the nerve fibers are damaged and erode away, leaving a larger cup (or hole of the doughnut).
Optic Nerve Fiber Analysis
The optic nerve is composed of over one-million individual nerve fibers/axons. Analysis of the number of optic nerve fibers helps our doctors obtain objectivity for how much glaucoma damage you may have. Optical coherence tomography (OCT), Glaucoma Diagnosis Analyzer (GDx), and the Heidelberg Retinal Tomography (HRT) are currently used in clinical practice to help achieve this purpose. Currently, OCT is the most popular technology used by glaucoma specialists for optic nerve fiber analysis.
Visual Field Testing
The Visual field is used to analyze optic nerve function in carrying visual information to the brain. This subjective test uses a varying light spot size and intensity to measure you central and peripheral vision, to help diagnose the severity of your glaucoma.
Gonioscopy is where with the utility of a gonio-lens (a unique lens) and a slit lamp (microscope) our doctors examine the drainage system of your eyes. This is painless and takes less than 10 seconds to do. The drainage system or the angle is located where the white part of the eye (the sclera) and colored part of the eye (the iris) come together (called the angle). Our doctors need to ascertain whether your angles are open or closed, better understanding why your intraocular pressure maybe elevated.
Tonometry is a procedure performed to determine one’s eye pressure, also known as intraocular pressure (IOP). This is an important test in the evaluation of glaucoma and its management. Most tonometers are calibrated to measure pressure in millimeters of mercury (mmHg). And they can be performed through many different methods including a “puff of air” also called pneumatonometry or “direct contact” applanation tonometry.
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Several glaucoma treatment options exist and the choice of which treatment strategy to pursue can depend on which type of glaucoma exists. Options include drops, laser, surgery and pills.
What is Glaucoma?
Glaucoma is a condition where the pressure inside the eye (also called intraocular pressure) is elevated, causing damage to the optic nerve (the nerve that connects the eye to the brain).
Narrow Angle Glaucoma
Narrow-angle glaucoma occurs when the colored portion of your eye (iris) is pushed or pulled forward causing blockage of the drainage angle of the eye, leading to a rise in intraocular pressure.