Glaucoma Diagnosis

  • Diagnosis

    Your doctor will diagnose you with glaucoma if you meet certain conditions. By looking in the back of your eye, known as your fundus, your primary care doctor may notice changes in your eye disk, called cupping. If he or she sees this on office exam, you should be referred to an eye doctor.

    You might be diagnosed with increased IOP in a community-based screening or if you are having your eyes checked while you buy new glasses. Having increased IOP does not necessarily mean you have POAG, but you should be referred for a complete exam by an eye doctor.

    Several tests are available to determine if you have increased IOP. These include the Schiotz method, in which your eye doctor will numb your eye then press a tonometer next to your eye to measure the pressure. Your doctor may put an orange dye in your eye and then measure the pressure while taking a close look at your eye with a slit-lamp. This is called the aplanation method. The puff test may also be used. This technique can measure your IOP by blowing a tiny amount of air into your eye, and measuring the force needed to indent your eye. Normal eye pressures range from 10 to 20 mmHg. If your pressure is higher than that, your doctor will probably perform additional tests.

    If you have increased IOP, your eye doctor will check the thickness of your cornea, using tachymetry. To perform this test, your doctor will numb your eye with drops and then use an ultrasound machine to measure how thick your cornea is. If your cornea is thin, you have a higher risk of developing POAG.

    If these tests suggest you could have glaucoma, you will be closely examined for optic nerve damage. Your doctor will use an ophthalmoscope or bioscope to look directly into your eye; he/she may take pictures using a computer and special camera to closely examine your optic nerve.

    It is important for you to take all the medications your doctor prescribes, keep your appointments, and notify your doctor if your vision begins to worsen.

    Ask your doctor about medicine you can take by mouth to help treat glaucoma.

    If eye drops and pills are not effective in treating your glaucoma, your eye doctor may recommend a type of surgery called a trabeculectomy, or a filtering procedure. Trabeculectomy would open up passages in your eye to improve the flow of aqueous humor. You would receive antibiotic eye drops following the procedure and go back to see your eye doctor for follow up. You may need to have this procedure repeated a few times for the pressure in your eye to really improve. A trabeculectomy will not improve your vision, but it can help prevent your vision from getting worse.

    There are no known alternative medicine treatments for glaucoma.

    Laser therapy can also be an effective treatment for POAG. Your eye doctor can do this quick procedure in the office. This procedure allows more of the eye fluid to drain.

    Many people with glaucoma take prescription eye drops. You can ask your doctor about which eye drops would be best for you.

    Screening for glaucoma can help prevent severe visual loss, but not all medical societies agree on how often to screen people. The American Academy of Ophthalmology recommends that everyone over age 40 have a full eye exam and a test for IOP. If you are not at high risk for glaucoma, you should have a repeat screening exam every 3 to 5 years. If you have a higher risk for glaucoma and/or you are over the age of 60, you should get a screening exam every 1 to 2 years.

    Childhood glaucoma is a rare condition that occurs in infants and babies within their first year. Children with this condition may have sensitivity to light and a cloudy cornea. Early diagnosis and treatment can help babies and children retain normal vision.

  • Prevention and Screening

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