Glaucoma Assessments

Glaucoma is diagnosed through a comprehensive eye examination. To establish a diagnosis of glaucoma, several factors must be present: Because glaucoma is a progressive disease, meaning it worsens over time, a change in the appearance of the optic nerve, a loss of nerve tissue, and a corresponding loss of vision confirm the diagnosis. Some optic nerves have a suspicious appearance, resembling nerves with glaucoma, but the patients may have no other risk factors or signs of glaucoma. These patients should be closely followed with routine comprehensive exams to monitor for change.

Testing includes:

  • Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems and family history that may be contributing to the problem.
  • Visual acuity measurements to determine the extent to which vision may be affected.
  • Tonometry to measure the pressure inside the eye to detect increased risk factors for glaucoma.
  • Pachymetry to measure corneal thickness. People with thinner corneas are at an increased risk of developing glaucoma.
  • Visual field testing, also called perimetry, to check if the field of vision has been affected by glaucoma. This test measures your side (peripheral) vision and central vision by either determining the dimmest amount of light that can be detected in various locations of vision, or by determining sensitivity to targets other than light, and comparing it to others of similar age.
  • Evaluation of the retina of the eye, which may include photographs of the optic nerve, in order to monitor any changes that might occur over time.
  • Supplemental testing may include gonioscopy, a procedure allowing views of the angle anatomy, the area in the eye where fluid drainage occurs. Serial tonometry may be performed. This is a procedure acquiring several pressure measurements over time, looking for changes in the eye pressure throughout the day. Other tests include using devices to measure nerve fiber thickness, and look for specific areas of the nerve fiber layer for loss of tissue.