Glaucoma

An Overview
Glaucoma is a condition characterized by the following 3 things:

1. Increased intra ocular pressure
2. Optic nerve damage
3. Visual field loss which can lead to blindness.

What tests are used to diagnose glaucoma?
There are 5 tests used to determine if a patient has glaucoma. These tests must be interpreted as a group and no one test can determine is a patient has glaucoma. The 5 tests are:

• Intra ocular pressure
• Dilated fundus exam
• Synemed visual field
• Heidelberg 3-D Retinal Tomography
• Gonioscopy

These tests will be performed over a span of 3 to 4 visits. After the results are collected, they will be analyzed by Dr. D to determine if a patient has glaucoma. Dr. D will also assess the risk for the patient's risk of developing glaucoma in the future if they do not have it at the present time.

Once all the above tests have been analyzed, Dr. D will determine a "TARGET PRESSURE".

The target pressure will guide all future therapy. An example will make this concept clear.

When Dr. D suspects that a patient may have glaucoma, the patient will undergo the 5 tests mentioned above to create a clear picture of the person's ocular status. There is no simple single test to determine glaucoma. Using these 5 tests, Dr. D will set a target intra ocular pressure.

The 5 tests are interpreted as a group to set the target pressure. Recent studies have shown a significant benefit to early laser and medical treatment. Treatment must be considered in light of other factors such as cost, convenience and risk. If the intra ocular pressure increases above the target pressure, Dr. D may recommend a pressure lowering eye drop to decrease the intra ocular pressure or may recommend laser surgery. (Normal intra ocular pressure is less than or equal to 21.)

As long as the 5 tests remain stable, the target pressure will remain at its original level. Repeating the 5 tests on a regular basis is necessary to determine progression. Repeating these tests give crucial information on how a person's glaucoma is progressing. If repeat tests show increasing damage, then the target pressure will be lowered in an attempt to prevent further damage.

If all the above seems complicated, don't feel confused. Glaucoma IS A COMPLICATED CONDITION. Glaucoma is very complex due to the many ways it can present AND because it cannot be easily diagnosed without extensive testing.

SOME PEOPLE GET FRUSTRATED with the uncertainty of Glaucoma, which is understandable. After all, the thought of losing your sight can be scary. Rest assured that Dr. D is highly trained in this area and will provide you with the best care possible for your condition. We will answer any questions that you may have and we will do our best to make you feel comfortable with your care.

If you have any questions, please ask, the more you understand your condition, the better chance we have of preserving ALL YOUR VISION.

One last comment...
Because Glaucoma is one of the leading causes of blindness in America, it is very important that we maintain a consistent watch on your eyes. Glaucoma has no symptoms and in most cases, patients CANNOT TELL WHEN THEIR INTRA OCULAR PRESSURE IS HIGH.

Please keep your appointments and take your medication (if prescribed) as directed. This will minimize your risk of serious vision loss. Dr. D is committed to preserving your vision, we simply ask for your cooperation in managing this complex condition.