Glaucoma Diagnosis

Regular eye examinations are the best way to detect glaucoma.

 Your Visual Acuity will be assessed using the Snellen eye chart which measures how well each eye can see.  During an examination, our doctors will evaluate your intraocularpressure (IOP) by Tonometry.  A high eye pressure reading is often one of the first indicators of glaucoma.   The thickness of the cornea is measured by pachymetry, because corneal thickness affects eye pressure readings.  At the Slit Lamp Microscope, the doctor will inspect the drainage angle during a procedure called Gonioscopy.  An Optic Nerve Exam, performed when the pupils are dilated, is necessary to detect optic nerve damage.  

diagnostic testing for glaucoma

Additional Tests may be ordered that allow unique views and analysis of the state of your optic nerve, comparing the way the optic nerve appears during the test to a database of other individuals categorized by age, gender, race, and level of glaucomatous damage.

 A Humphrey Visual Field (HVF) or Frequency Doubling Technology (which detects damage faster and earlier in the disease process) analysis of your current amount of peripheral field loss will be ordered.   The Ocular Coherence Tomographer, (OCT) scans through your dilated pupil to assess the quantity and quality of the optic nerve fibers themselves.  The Heidelberg Retinal Tomographer (HRT) scans the appearance of the optic nerve, including changes in its shape and appearance over time.  In Glaucoma, the elevated eye pressure permanently damages these fibers.  Tracking the amount of nerve fiber loss helps your doctor in determining when and if to intervene with additional glaucoma treatment.   Digital Optic Nerve Photographs or 3–Dimensional Optic Nerve Photographs will be taken to aid in the further evaluation of your optic nerve’s appearance over time.  Blood flow to the microscopic cells of the optic nerve is an important factor in optic nerve health, and may be assessed through Ocular Blood Flow Analysis and 24-hour Blood Pressure Monitoring (similar to wearing a Holter monitor). 

Three scans are taken of the optic disc and nerve fiber layer. These are combined to create a high quality, 3-D topography. Our research at the Eye Research Foundation set the standard protocol for how to measure ocular blood flow.

EFEI has the FDT which can detect visual field loss in perimetrically normal eyes with open-angle glaucoma. Recently, research has indicated that a technology known as FDT is very useful in detecting visual field loss secondary to glaucoma.  Additionally, this same technology has also been shown to predict the visual field loss pattern that would be seen on standard testing.  

At East Florida Eye Institute, we make use of this technology daily, and feel we enhance service to our patients with the addition of this technology.  On a regular basis, we are able to give our patients thorough, consistent and useful information regarding the status of their eye health; including, but not limited to glaucoma.  With the addition of the FDT technology to the practice, we have been able to increase quality and exceed patient's expectations. 

 Exciting New Developments in Reversing Blindness

•Scientists at Harvard have shown that until about the age of two, the neurons in the human brain are still growing
•They have found a molecule (SOCS3)  that appears to put the brakes on neuron growth in adult mice. 
•They also found that damaged neurons sprout after blocking this molecule in adult mice with crushed optic nerves
•This work is an important advance towards understanding why axons of adult nerve cells don't regenerate. 
•In future the ideal treatment will probably involve delivering drugs to an injured area of the brain or spinal cord so that the nerve tissue re-grows especially in conditions like Alzheimer’s disease and Glaucoma.