WHAT IS GLAUCOMA?

Glaucoma is a disease of the optic nerve often associated with increased intraocular pressure (IOP).

Elevated IOP alone is not enough to make the diagnoses of glaucoma. Some patients may have glaucoma when their IOP is within normal limits. This is called Normal Tension Glaucoma (NTG). Conversely many patients have IOP elevation and never develop glaucoma. This is called Ocular Hypertension (OHT).

If you are confused by this, don’t worry, you are not alone. Most patients and many physicians have difficulty understanding glaucoma. We are used to concentrating on numbers. Hypertension is defined as blood pressure above 140/90. Diabetes is followed by measuring the blood sugar and the hemoglobin A1C (HgbA1C). So it is natural for the IOP measurement to be the focus of glaucoma diagnoses and treatment.

But glaucoma is different from hypertension and diabetes.  Aside from intraocular pressure measurements the function and structure of the optic nerve must be evaluated when evaluating glaucoma. Calling IOP measurements a “glaucoma test” and the use of IOP measurements in “glaucoma screenings” is inadequate and misleading.

The best way to evaluate a patient for glaucoma is:

1. - Obtain a complete medical history including a review of systems and family history concentrating on a family history of glaucoma and a history of migraine.
2. - Visual acuity, slit lamp exam, IOP measurement and careful examination of the optic disc are the minimum examination techniques required in glaucoma evaluation.

If the medical history is negative and the physical eye exam normal then this is an adequate “glaucoma screening.” IOP measurement alone is not good enough.

If the medical history is positive or the eye exam suspicious then further testing is necessary, such as ultrasonic pachymetry – measurement of corneal thickness, computerized visual field testing and photographic imaging of the optic disc. The optic disc is the portion of the optic nerve that is visible when looking at the ocular fundus, the inside of the eye.

I have only touched on the surface of glaucoma evaluation. More information is available here, here, here and here.

Noah Klein, MD

Noah Klein, MD, PC

August 13, 2009

January 3, 2010

This is another good link about glaucoma:

http://www.travatanz.com/High-Eye-Pressure.aspx

Related Posts

• VIRAL CONJUNCTIVITIS - PINK EYE Dr. Noah Klein Noah Klein, MD, PC August 4, 2009 Red eyes with itching, tearing, clear discharge and a foreign body sensation (feeling of something in the eye) can be caused by a virus. This is called viral conjunctivitis or “pink eye” and can be quite uncomfortable.It may be difficult......
• Senator Barak Obama Has A Head Tilt August 18, 2008 Noah Klein, MD Noah Klein, MD, PC   Senator Barak Obama Has a Right Head Tilt    Watching the Saddleback Church Forum with Pastor Rick Warren interviewing Senator Barack Obama on Saturday August 16, I was struck by the marked and obvious tilting of the Senator’s head......
• Conjunctival Hemorrhage - Blood in the Eye One of the most frequent "emergency" visits in my office is due to a conjunctival hemorrhage. This is what it looks like: /caption] Although this looks dramatic and scary it is quite harmless most of the time especially if not accompanied by any discomfort and without a history of trauma......
• Ocular Melanoma and Routine Ophthalmoscopy August 6, 2008 Noah Klein, MD Noah Klein, MD, PC   Ocular Melanoma and Routine Ophthalmoscopy   I examined a 50 year old healthy woman today who came in for stronger reading glasses.  Because she had not had a dilated eye exam (ophthalmoscopy) for years I dilated her pupils and......
• 9/11 9/11 Walking to my office on East 25th Street in Manhattan on the morning of September 11, 2001 I was struck by the beautiful clear sunny sky.  Like everyone else enjoying the fall weather I did not know how terrible this day would be for my city and my country.......
• EYE PAIN When a patient complains of eye pain asking the right questions often helps determine the cause of the pain. This makes the diagnosis and treatment easier. It is helpful to distinguish between eye pain caused by external factors such as a foreign body on the surface of the eye and......
• Computer Vision Problems Computer glasses and eye strain computer vision syndrome   Do your eyes hurt or burn when looking at a computer screen? Do they tear, or feel tired after hours of computer use? Do you get headaches after staring at a CRT or LCD computer screen? Do you have neck or......

Related Websites

• Choosing Hunting Optics Selecting hunting optics is going to be a really big priority if you are a hunter or a rifle shooter. Having good optics is going to give you a serious advantage when it comes to general accuracy as well as long distance shooting accuracy. Some of the optics that you......
• Stem Cell Contact Lens Help Blind To See Again Image via Wikipedia Stem Cell Research using the patient’s own Adult Stem Cells has brought us another great discovery- Stem Cell Contact Lens. In Australia, a group of doctors in a research study treated 3 patients who had some form of cornea problems and they all were able to......
• A99 Golf DIGITAL 7x GOLF RANGE FINDER GOLFSCOPE SCOPE User Reviews Send this to a friend A99 Golf DIGITAL 7x GOLF RANGE FINDER GOLFSCOPE SCOPE Manufacturer: A99 Golf Customer Rating: List Price: Varies based on product options Sale Price: $49.99 Availibility: Usually ships in 1-2 business days Buy Now Product Description Pocket Size: 3.75" (Length) x 2.0" (Width)......