Testing for glaucoma
A comprehensive examination for glaucoma includes:
- checking visual acuity and measuring intraocular pressure
- determining the visual field
- measuring corneal thickness (pachymetry)
- checking optic angle (gonioscopy)
- examining and checking for damage to the optic nerve by using optical coherence tomography (OCT)
At the start of the examination, the doctor enquires detailed information about the reason for the patient's arrival. In addition to the current problems of the patient they try to get more accurate information about their current state of health and possible eye diseases in the family. Then they check visual acuity and conduct an examination with the slit-lamp that defines the current state of the front and middle segment of the eye.
After that, the patient is reffered for visual field testing to be performed by specialized health professionals. The examination is painless, but requires a high concentration which can prolong this search up to an hour, depending on the compliance of the patient.
After the examination, the patient returns to the specialist unit where a doctor measures the intraocular pressure. During the procedure anesthetic eye-drops are administered so that the search is not unpleasant. The same drops are administered during the following examination called gonioscopy which is used to establish the iridocorneal angle. The examination is performed with gonioscopic lens which lies directly on the surface of the eye and is completely painless. Certainly the patient must be informed about all the steps of this examination in order to achieve better compliance.
If the width of the corner of the eye allows it, the pupil expands as the result of eye-drops so that the examination of the optic nerve and macula could be performed in the best way possible. The OCT apparatus helps significantly, which is used to perform optical coherence tomography. This is also a non-invasive test that provides reliable information on possible damage to the optic nerve and macula. This part of the examination can last from 30 to 60 minutes depending on the speed of expansion of the patient's pupils. Due to the extended pupils which shrink after a few hours, operating a vehicle is not recommended within that time since the vision is blurred and there is sensitivity to light.
In the final stages of the examination the doctor combines all the findings and decides on the treatment on that basis, if the treatment is necessary. The initial treatment is medication in the form of eyedrops which are applied in the eyes. If necessary, the treatment can be supplemented by laser treatment, and if that is not enough the patient is sent to a surgery which is aimed at lowering intraocular pressure to normal values.