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THE GLAUCOMA EXAMINATION
by Dr Maria Hannah Pia de Guzman
Glaucoma can be detected when the patient is examined in the ophthalmologist’s clinic. The part of the optic nerve that is inside the eyeball, called the optic disc or optic nerve head, can be seen when the doctor looks inside the eyeball using special lenses and lights in an examination technique called funduscopy. The doctor can determine if the optic nerve head looks normal, suspicious, or definitely abnormal. Due to the wide variation in the appearance of normal optic discs this determination can sometimes be tricky.
The part of the eye where the intraocular fluid naturally drains (the trabecular meshwork, located in the anterior chamber angle) can be viewed with special lenses in an examination called gonioscopy. The doctor can see if the meshwork is blocked (“closed”) or not (“open”).
Another aspect of the eye examination is measuring the pressure inside the eyeball (intraocular pressure) because this may be elevated in cases of glaucoma. This examination is called tonometry and there are many different instruments that can be used.
After the examination the doctor considers the patient’s history and the findings and decides whether to request for some diagnostic tests and/or recommend glaucoma treatment.