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Thursday, 28 November 2013

Glaucoma – The Diagnosis

Glaucoma is a medical condition of an eye disease as result of the damage of the nerve of eye’s optic over time. If left untreated, it can lead to permanently vision impair and blindness.
B. Diagnosis
If you are experience some of the above symptoms, after recording your family history and complete physical examination, including a comprehensive eye examination, the tests which you doctor orders may include
1. Test for intraocular pressure
The aim of the totometry is to measure the internal eye pressure, after numbing your eyes with drops. Unfortunately, in the study to compare intraocular pressure (IOP) measurements by Perkins tonometer and Tono-Pen in young children with primary congenital glaucoma (PCG), found that Tono-Pen readings disagree with Perkins tonometer measurements for measuring IOP in children with PCG who present with IOP greater than 16 mm Hg and tends to overestimate IOP(21).
2. Optic nerve damage testA medical instruments used by your doctor to look directly through the pupilinto the back of your eye. Any damage to the optic nerve may be an indication of early case of glaucoma.
3. Visual field test
The aim of the eye examination that can detect dysfunction in central and peripheral vision.
4. Visual acuity
the aim of the examination is to test how far distance that you eye can see.
5. Test for cornea thickness (pachymetry).
The aim of the test is to determine the thickness of each cornea, According to the study by the Sungkyunkwan University School of Medicine, in comparison of the potential differences in the phenotypes between Western normal-tension glaucoma (NTG) and Korean NTG. Korean NTG patients showed steeper cup shapes, thicker RNFL thickness, and thinner central corneal thickness compared with Western NTG patients with similar amounts of visual field loss. This result may help clinicians understand the clinical characteristics of NTG patients and points to the heterogeneous character of the glaucomas(22).
6. Gonioscopy
Gonioscopy is the test with the use of a gonioscope in conjunction with a operating microscope
to examine the the drainage angle to distinguish glaucoma, such as open-angle glaucoma and angle-closure. According to the stduy by the The University of Michigan, the examination of Gonioscopy include beginning the examination with the inferior anglewith the inferior angle, methods to help in looking over the iris, cycloplegia, locating the corneal wedge, indentation, van Herick estimation, examining the other eye, and topical glycerin(23).
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Sources
(a) tp://www.glaucoma.org/glaucoma/types-of-glaucoma.php
(21) http://www.ncbi.nlm.nih.gov/pubmed/16102480
(22) http://www.ncbi.nlm.nih.gov/pubmed/23352340
(23) http://www.ncbi.nlm.nih.gov/pubmed/15513458