Glaucoma

The whole idea in glaucoma management is to detect and treat before it has gone too far. The eye doctors at Ticho Eye Associates provide comprehensive evaluation and treatment, including medical, laser, and surgical treatments for glaucoma.

How do we tell if a person has glaucoma, or how severe it may be? Glaucoma evaluation revolves around three components: the eye pressure, what the optic nerve looks like, and the status of the visual field (side vision). In general, no one of these three components will tell enough of the story to make a definitive judgment. Some patients may tolerate a high pressure, for example, while others may go blind with a statistically normal pressure. In general, however, the higher the eye pressure, the higher the risk.

A diagram of a normal eye verses an eye with glaucoma

Similarly, the appearance of the optic nerve gives important clues. If the nerve has been pushed on hard enough, long enough, it forms a large central depression, or cup. The larger the optic cup, in general, the higher the risk. However, some people have naturally large cups, making things look worse than they really are.

Finally, the side vision will give a clue to disease progression long before it becomes noticeable to the patient. Testing the side vision with a visual field, involves finding the dimmest light a patient can see in a particular position in their peripheral field. How bright do we have to turn up the light before you can see it?

Diagram showing the symptoms of Glaucoma

Particular glaucoma tests performed at Ticho Eye Associates include:

  • Tonometry: Assess the eye pressure
  • Ophthalmoscopy: inspect and photograph the visible portion of the optic nerve
  • Visual field test: Measure the side vision
  • Optical coherence tomography (OCT): Analyze the thickness of the optic nerve fiber layer
  • Gonioscopy: Visualize the eye’s drainage system