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Diagnosing Glaucoma

The only sure way to diagnose glaucoma is with a complete eye exam. A glaucoma screening that only checks eye pressure is not enough to find glaucoma.
During a glaucoma exam, your ophthalmologist will perform:

  1. Applanation Tonometry – A measurement of your eye pressure.
  2. Gonioscopy – An inspection of the drainage area of your eye to determine if it is open, narrow or closed. A special mirrored lens is used to view this structure.
  3. Ophthalmoscopy – A microscopic examination technique used to evaluate the optic nerves to look for signs of damage from glaucoma. This is best performed after pupil dilation.
  4. Visual Field Testing – A test of your peripheral (side) vision. This allows detection of subtle changes to the vision of which you may not be aware and allows for monitoring of changes over time.
  5. Pachymetry – A measurement of your corneal thickness. This test allows further interpretation of your intraocular pressure measurement.
  6. Computerized Optic Nerve Imaging – There are several different devices currently available to assess the optic nerves.
    These include:
  1. Stereoscopic Photographs of the Optic Nerves: This provides three-dimensional photographs of the surface of your optic nerves to look for signs of damage from glaucoma.
  2. Optical Coherence Tomography (OCT): This provides computer-generated measurements of the retinal nerve fibers that join together to form the optic nerve. Damage to these fibers is an extremely sensitive marker for glaucoma. This test allows a very accurate comparison of your retinal nerve fibers from year to year.
  3. Heidelberg Retina Tomography (HRT): This provides a computer-generated three-dimensional map of the surface of the optic nerve to look for signs of damage from glaucoma. This test allows a very accurate comparison of your optic nerve from year to year.