Section 6-A: The glaucoma eye examination and diagnosis. What to expect.

An eye examination to assess for glaucoma is not very different from the standard check-up visit conducted by an eye doctor. In fact, many elements of a glaucoma evaluation are routinely conducted at all visits to an eye doctor. These glaucoma vital signs are listed in Table 6-1 and are discussed in detail below. The elements of this examination are painless and well-tolerated by most patients.

Some parts of a glaucoma examination are done at every visit, while other parts are evaluated less frequently. Visual acuity, intraocular pressure (IOP), and the optic nerve appearance are assessed at every visit, while the drainage angle and peripheral vision are measured at regular intervals (typically once a year or so).

Color photographs are taken of the optic nerve using a camera that is focused through the pupil towards the back of the eye. These pictures document the appearance of the optic nerve at a particular timepoint. The photos are used by the eye doctor to help recognize progressive damage to the nerve (increased cupping) by allowing a comparison of the current optic nerve appearance to a prior photograph.

Specialized imaging devices such as an Optical Coherence Tomograph (OCT), Heidelberg Retinal Tomograph (HRT), or a scanning laser polarimeter (GDx) may also be used to help assess the health of the optic nerve. These instruments take images of the optic nerve and retina similar to a photographic camera. However, the images captured by these devices are used to quantify the amount of cupping and thickness of the fibers that make up the optic nerve.

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