One of the things that has changed the most about the clinical care is the approach to detecting and diagnosing Glaucoma. When I started practicing, Glaucoma was thought to be a disease of the optic nerve caused by excessive pressure inside the eye. We measured the pressure inside the eye and looked at the optic nerve on a regular basis and figured that we were doing all that we could and should for our patients.
Along came the microprocessor and the whole game changed. We now had better ways to measure the function of the optic nerve (testing referred to as Visual Field Testing) since the computer could do a better and more accurate (not to mention faster, which is very patient friendly) job of evaluating our patient’s vision. We also started to find more and more patients who sufferedn from progressive damage to the optic nerve, even though we felt that we had their pressure well controlled. I started to see enough of these patients that I wondered if we were doing some of our Glaucoma patients any favors by treating them with drops or surgery to lower their pressure.
In the last few years, we have gained the ability to measure the structures in the back portion of the eye such as the optic nerve and macular thickness and we’ve started to understand the disease a bit better. We now know that quite a bit of structural damage can occur before we see consistent change in the visual fields of our patients. The visual field test is quite subjective, meaning that if the patient “has a bad day” or is otherwise distracted, the data from that day’s test may be inaccurate and result in compromised decision making on our part. New technology such as the Retinal Thickness Analyzer that we use in our office however, helps take teh subjective testing problems out of the equation, giving us objective ways to evaluate our patient’s ocular health.
So why did I bore you with this long blog post? Just to let you know that we are using the latest and greatest technology at Warren Eye Care to detect Glaucoma as early as possible in our patients! We use the Vision Wellness Examination that the Retinal Thickness Analyzer performs as part of our quest to detect and appropriately treat vision threatening conditions as early as possible.