LIVING WITH GLAUCOMA

People who are told they have glaucoma often fear vision loss.  The good news is almost all patients, with proper treatment, usually keep their vision.  Early diagnosis can usually prevent glaucoma from causing significant vision loss.

Glaucoma has very few symptoms, except when the pressure gets very high.  Most patients do not know they have glaucoma.  Most people are diagnosed with glaucoma at their routine yearly vision exam.

If you have been diagnosed with glaucoma, you are usually prescribed medications to treat this.  Click Here to see methods of treatment.  Often your pressure can be lowered enough with one drop put in just before bedtime.  If one drop does not lower your pressure to desired levels, a second and sometimes a third drop is prescribed.

Other than taking your medications, glaucoma should not interfere with your life.  Borderline patients are seen every six months to one year.  If you are diagnosed with glaucoma, you will usually see your optometrist\doctor three to four times per year. 

Visits and workup will consist of:

1.  Pressure Testing, also called Tonometry
During routine vision exams, pressures are often tested with "puff" or "pulse" air impulse measuring devices.  Normally actual touch methods, which are more accurate are used to monitor and diagnose glaucoma.  Below are pictures of each.

TOUCH OR APPLINATION PRESSURE TESTING

HAND HELD PUFF/PULSE TONOMETER 

2. Visual Fields.  During this test, you stare into an instrument and press a button every time you see a light.  This will than map out what you can or cannot see.  This is called a visual field.  Patients with glaucoma loose vision over time.

VISUAL FIELDS INSTRUMENT

3.  Photographs of the back of your eye to monitor any changes.  These pictures are called retinal photos.  They can be taken with special eye cameras.  Your eye may need to be dilated for this.   Pictures of glaucoma are on the photographs page

4. Gonioscopy - Your optometrist/doctor will place a special mirrored lens on your.  With this he/she can see into the angle made by the colored part of your eye (iris) and the clear bulb structure (cornea).  A wide open angle between the cornea and iris allows for better fluid drainage.  A narrow angle decrease fluid drainage in your eye and increases pressure.
    Two gonioscopes are shown below.  The black one is a three mirror the silver one is a four mirror.  The mirrors are angled to see the angle between your cornea and iris.

GONIO LENSES

5. Retinal Thickness Measurements - This is a newer technology that measures very accurately the thickness of your retina.  In glaucoma, a thinning of the nerve fiber layer (a layer in the retina) occurs.  Your thickness can be compared to average readings to determine if you have a thin or thick retina.  This measurement can also be used to monitor changes that occur.  A printout of this instrument is show on the "Diagnosing Glaucoma" page.

OPTICAL COHERENCE TOMOGRAPHER (SHOWN BELOW)

6. Corneal Thickness or Pachymetry:  The corneal is the front clear bulb of the eye where contact lenses are placed.  If the cornea is thick, pressure readings taken by your doctor are often to high.  Thus, your doctor needs to adjust your pressure DOWN a little from any reading taken.  Corneas that are thicker also are LESS likely to develop glaucoma. 
    The opposite is the case for thin corneas.  People with thin corneas are more likely to develop glaucoma AND their pressure readings need to be adusted UP. 
    Below is a ultrasound pachymeter.  The black probe vibrates thousands of times per second.  When it is touched lightly to the cornea, a digital read out of the eye thickness is obtained.

ULTRASOUND PACHYMETER BELOW