Any Optometrists in the house???
20 December 2002, 11:29 AM
#1
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So I went and got an eye test today (need and got reading glasses), during which they did a test for glaucoma and I got a referral to a specialist..
Now the results of the glaucoma tests were:
High Iops
Right eye 26/27 mmHg
Left eye 24/23 mmHg
(applanted)
Please re-assess
Now the optmetrist didn't seem too concerned ( and there is no family history)
But I was wondering, just how bad potentially these results were ??
Richard ( now getting used to typing looking through specs )
Now the results of the glaucoma tests were:
High Iops
Right eye 26/27 mmHg
Left eye 24/23 mmHg
(applanted)
Please re-assess
Now the optmetrist didn't seem too concerned ( and there is no family history)
But I was wondering, just how bad potentially these results were ??
Richard ( now getting used to typing looking through specs )
20 December 2002, 09:07 PM
#3
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Glaucoma diagnosis is based on three factors:
1. Raised IOP (intraocular pressure of the "aqueous")
2. Characteristic visual field loss
3. Change in appearance of the optic nerve head
There are various subtypes depending on which of the three you have. It is usually the ongoing pressure that starves the retina of nutrients leading to the visual loss and the changes in appearance of the optic nerve head, although glaucoma can occur with normal pressure.
Methods used by optometrists very greatly in their accuracy in detecting eye pressure. The most common method used in the UK is non-contact tonometry where a puff of air is blown at the eye. Ophthalmologists usually use a contact method where a prism is used gently against the anaesthetized cornea to detect the pressure inside the eye. All the measurement methods are subject to errors, the non contact methods can be inaccurate in particular.
Treatment can vary from nothing at all (not required because the form you have is not aggressive and you just require regular follow up) through to drops to reduce the production of aqueous in the eye (which is under higher pressure), enhance absorption of the aqueous, and sometimes operations to assist a low pressure state within the eye.
Much less common is acute glaucoma which leads to sudden onset eye pain, halos around lights, sometimes vomiting and abdominal pain and abrupt visual loss. This is not the sort of thing the optometrist picks up on a routine eye check where someone is not complaining of obvious symptoms.
If you do genuinely have raised pressure there is a heck of a lot that can be done (if necessary) to control it, but you need that specialist opinion to keep you right on how to proceed.
About 2/3 of the referrals I get as a GP from Optometrists to get an Ophthalmological opinion are red herrings I have to say - a lot are over cautious, which is not bad thing at all. They find an abnormality, it is the Ophthalmologist's job to interpret the significance of it.
Hope this helps - if the language is either too basic or too daft just ask and I will clear up what I can for you.
BTW normal IOP is considered to be 15 to 21mmHg, yours are a bit over this, sounds like the second lot were done with applanation (ie the contact method I mentioned above) so this is a bit more reliable. Don't worry, it just needs to be investigated further.
[Edited by john banks - 12/20/2002 9:13:32 PM]
1. Raised IOP (intraocular pressure of the "aqueous")
2. Characteristic visual field loss
3. Change in appearance of the optic nerve head
There are various subtypes depending on which of the three you have. It is usually the ongoing pressure that starves the retina of nutrients leading to the visual loss and the changes in appearance of the optic nerve head, although glaucoma can occur with normal pressure.
Methods used by optometrists very greatly in their accuracy in detecting eye pressure. The most common method used in the UK is non-contact tonometry where a puff of air is blown at the eye. Ophthalmologists usually use a contact method where a prism is used gently against the anaesthetized cornea to detect the pressure inside the eye. All the measurement methods are subject to errors, the non contact methods can be inaccurate in particular.
Treatment can vary from nothing at all (not required because the form you have is not aggressive and you just require regular follow up) through to drops to reduce the production of aqueous in the eye (which is under higher pressure), enhance absorption of the aqueous, and sometimes operations to assist a low pressure state within the eye.
Much less common is acute glaucoma which leads to sudden onset eye pain, halos around lights, sometimes vomiting and abdominal pain and abrupt visual loss. This is not the sort of thing the optometrist picks up on a routine eye check where someone is not complaining of obvious symptoms.
If you do genuinely have raised pressure there is a heck of a lot that can be done (if necessary) to control it, but you need that specialist opinion to keep you right on how to proceed.
About 2/3 of the referrals I get as a GP from Optometrists to get an Ophthalmological opinion are red herrings I have to say - a lot are over cautious, which is not bad thing at all. They find an abnormality, it is the Ophthalmologist's job to interpret the significance of it.
Hope this helps - if the language is either too basic or too daft just ask and I will clear up what I can for you.
BTW normal IOP is considered to be 15 to 21mmHg, yours are a bit over this, sounds like the second lot were done with applanation (ie the contact method I mentioned above) so this is a bit more reliable. Don't worry, it just needs to be investigated further.
[Edited by john banks - 12/20/2002 9:13:32 PM]
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