Glaucoma comes in many different “versions”, but it is common enough that it is likely you will know someone, or be related to someone, who has glaucoma.

And you may have it yourself.
 

Glaucoma can be gradual or sudden, related to other eye problems, be inherited or not, and be of big problem or less so. What we will do is sort out the risk, gain some understanding of status and tempo and then Institute any specific intervention for type.

Overall the management of glaucoma is managing the risk of loss of vision, so the important component is to identify what that risk is to start with and then apply the right amount of treatment for that problem.
 

Fundamental to treatment of glaucoma is the type, the other risk factors, and the rate of progression. We generally use three types of data to manage glaucoma: Eye pressure, Structural Nerve Tests, and Visual Field testing.
 

One is the intraocular pressure which can be measured in all sorts of different ways and at different times but represents something about the current risk and has a degree of prediction about future risk. Intraocular pressure thus can act as a lead index, giving some view about future rate of change. It is also the most important factor that we vary in treatment, whether using drops, laser, or surgery. All of our tonometers and technicians are calibrated for Clinical Trials and the information stored on our Electronic Medical Record which has been purpose built for managing Glaucoma.
 

The second piece of data that is used is a structural test. This is a piece of information that well tell us a little bit about how the optic nerve, the structure that gets affected in glaucoma, is faring. This is done with a combination of examination, photo photography and three-dimensional imaging. The latter is performed using an OCT in (ocular coherence tomography) which measures the retinal nerve fibre layer thickness and can be used for serial measurements. We use 2 NIDEK OCT machines that have dedicated retinal nerve fibre layer analysis programs, and can use wide field imaging and ganglion cell mass imaging as well. Both of these machines are networked and all information can be serially reviewed and analysed for change.

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The third piece of data is a functional test – this is the Visual Field test. This is a measurement of the mid-peripheral and central visual capacity using a standardised system for measuring visual sensitivity. This process is known as visual field testing or perimetry, and is performed on one of two latest generation Humphrey Visual Field testers (Perimeters) using the SITA Faster program which reduces testing time and fatigue. Both field machines are networked and all data is stored and analysed by a specific program (FORUM).