What if I had Glaucoma? This is Glaucoma Awareness Month and if there is a family history of Glaucoma and/or you have large optic nerves or other risk factors that need to be monitored from year to year, then you are at least a glaucoma suspect.
If I was the patient and knowing what I know, what would I like to know? First, as a patient, I would like to know what glaucoma is, what the difference is between being someone who could develop glaucoma, and who definitely has glaucoma. Secondly, I would also like to get some professional advice about how to determine if the person that is caring for me is doing an adequate job of both diagnosing and treating me.
First things first, glaucoma is a disease of the optic nerve and probably the most common optic nerve disease and often associated with high pressure within the eye. When an eye doctor tells you that you might have glaucoma, it is likely that two things have happened: the eye pressure is abnormally high and they have looked at your optic nerve and suspect that the nerve appearance could signal possible damaged by glaucoma. Sometimes you might have a mild elevation in pressure with no optic nerve changes and you might just be a glaucoma suspect.
So, if it was me, and Glaucoma was on the line, I would sit in the waiting room for a few minutes, and then go back to the exam room and have to deal with my doctor shining the bright light in my eyes… As far as I am concerned, this is the only way my doctor can really look into my eye and really evaluate the optic nerves. For my eyes, if glaucoma is on the line a picture is for tracking changes over time but not a tool to diagnose.
If my eye doctor thinks that I might have glaucoma, then certainly I would expect to have other test performed to help identify how far along the disease process is and what is the degree of advancement. A visual field test is the test to check for optic nerve damage that we call glaucoma. Glaucoma is diagnosed by a combination of the pressure of the eye, the appearance of the optic nerve, and the functioning of the optic nerve. Visual field test is done to determine if there is any loss of visual function from the pressure. Keep in mind that there is another test known by the acronym OCT (Optical coherence tomography) that could compliment the findings of the exam and the visual field test. Another useful test is called a pachymetry and it measures the thickness of the cornea to accurately reflect the real pressure within the eye. Pictures are very helpful in evaluating structural changes over time.
Our current treatments to lower eye pressure are all very good, but I also know that all treatments have some side effects, cost constraints and convenience issues. So at this time I would need to have a discussion where these concerns are taken into account including the frequency of visits, frequency of tests and what values we need to pay attention to evaluate for progression.
So, to wrap things up, IF I had glaucoma I would follow these simple steps:
- I would want to make sure that my doctor was diagnosing (eye exam, visual field test, and an OCT as a minimum) and treating me correctly.
- I would want to make sure that the tests that evaluate for glaucoma are being done in a timely fashion (at least every year an exam, visual fields, OCT and photos of the nerves).
- I would discuss any problems that I was having with the drops.
- I would seek help if I had any other problems such as anxiety in dealing with the disease. And lastly, I would keep in mind that when I work together with my doctor and we both do our job correctly, my outcome will be positive.