Primary Eye Care Associates

Spotlight on Glaucoma - Part 3

Jun 3, 2015 @ 11:48 AM — by Dr. Steven Chander
Tagged with: Glaucoma Perimetry Biomicroscopy Pachymetry Gonioscopy

Part Three: What is Glaucoma: Diagnosis

Glaucoma typically develops very slowly, (exception being narrow angle glaucoma) and is a lifelong condition.  Glaucoma, like diabetes, cannot be cured, but with proper medication and monitoring it can be controlled very well. With proper management, a patient with Glaucoma can have a lifetime of clear, comfortable vision without blindness.  Early diagnosis, ongoing treatment and monitoring ca provide reduced risk of vision loss or blindness.  Our state-of-the-art glaucoma center along with Dr. Chander can help manage your condition, and so can you!

Diagnosis: Because glaucoma can occur at infancy and all the way to senior patients without any symptoms, catching glaucoma early is very critical.  Fortunately along with the keen sense of our modern training and ongoing education with our physicians, technology has come a very long way to help pick up the most earliest forms of glaucoma In this third and final informational post on glaucoma, we will review the latest diagnostic instruments that every eye clinic should have to help not only diagnose, but to provide the best ongoing treatment and monitoring for our patients.  At Primary Eye Care Associates, we are proud to harbor the latest in glaucoma treatment and management right here in our convenient location. 

Perimetry: also known as visual field testing, is performed first as a screening in our clinic using what’s known as Frequency Doubling Technology.  This test picks up stroke, aneurysm, tumor and of course the beginning stages of glaucoma.  Visual field testing can help the doctor determine if your vision has been affected by glaucoma.  It is a very important test because glaucoma first tends to occur on the side vision first.

Biomicroscopy: also knows as slit lamp examination, uses a special magnified lighted view of the anatomy of the eye.  With this instrument the doctor can view the eye nerve (which is damaged from glaucoma) as well as the area where the fluid in the eye drains.  The focusing lens (where cataracts occur), the macula (where macular degeneration occurs) as well as many other parts of your eye can be viewed using this instrument.

Fuduscopic Examination: also known as the dilation or retina exam is performed using a special lens to allow the doctor a 3 dimensional view of the very back of the eye where the eye nerve is and the retina.  The retina is the only place in the body where naked blood vessels are found, and so, sometimes the earliest damages from other body diseases such as cholesterol, diabetes and high blood pressure can be first found in the retina.

Optical Coherence Tomography: also known as OCT testing is a critical test to monitor the progression of glaucoma.  Sometimes even the very best controlled eye pressures still lead to continued eye nerve damage.  This can of your eye nerve provides your doctor with a cross-sectional view of the nerve.   

 

Tonometry: measures the pressure within the eye created from the fluid that is constantly circulating to nourish the inside of the eye.   Commonly known as the “puff of air test” in most clinics, non-contact Tonometry is a very quick and easy screening of the fluid pressure in your eye.  Appliation tonometry is performed by many instruments, such as the “goldmann tononmeter”, the “perkins hand held tomometer, the I-care tonometer and the pascal tonometer.

Gonioscopy: using the slit lamp or biomicroscope, a gonioscope is applied to the front of your eye much like a contact lens is applied.  It has mirrors attached to the scope to allow the docor to vew the draining channel in the eye where the fluid that nourishes the inside of the eye drains.  Doctor’s use this to determine if you have open angle or narrow-angle glaucoma.

Stereo 3-dimensional High Resolution Photo:  Monitoring the condition of the eye nerve (optic nerve) is critical in ensuring no further damage is occurring to the eye nerve.  By taking high resolution photos’ of the nerve periodically to compare as time goes on is the very best way to continue best treatment methods.

Pachymetry:  Using an ultrasound this device measures the thickness of your cornea.  Corneal thickness is an important gauge in monitoring the eye pressure in your eye.  Many patients are falsely diagnosed with having ‘high eye pressure’ or glaucoma simply because their cornea thickness was never measured.  Some patients are using anti-glaucoma medications when they really don’t have to be.  Glaucoma is a tricky disease to diagnose and all the above tools above constitute proper diagnosis and continued proper monitoring against vision loss and blindness.

Part 4 of our posts on Glaucoma; we will discuss the latest in the types of treatment of the disease.  Stay tuned!

Click here to view our educational video on glaucoma.