How is glaucoma diagnosed ?

Glaucoma is typically diagnosed through a comprehensive eye examination performed by an ophthalmologist or an optometrist. The diagnosis involves several tests and evaluations to assess the health of the eyes and detect any signs of glaucoma. Here are the common methods used in the diagnosis of glaucoma:

Tonometry: Tonometry measures the intraocular pressure (IOP) of the eyes. High eye pressure is a significant risk factor for glaucoma. The most common method is the “air puff” or non-contact tonometry, where a gentle puff of air is directed onto the surface of the eye to measure the IOP. Alternatively, an instrument called a Goldmann applanation tonometer may be used, which involves gently touching the eye with a probe.
Ophthalmoscopy: Ophthalmoscopy, also known as funduscopy, is the examination of the optic nerve. The doctor will dilate the patient’s pupils using eye drops and use a specialized instrument called an ophthalmoscope to examine the optic nerve. Changes in the appearance of the optic nerve, such as cupping or thinning, may indicate glaucoma.
Perimetry: Perimetry, or visual field testing, measures the full extent of a person’s field of vision. It helps detect any peripheral vision loss, which is a common sign of glaucoma. During the test, the patient focuses on a fixed point and indicates when they see lights of varying intensity in their peripheral vision.
Gonioscopy: Gonioscopy is a procedure that examines the drainage angle of the eye. The doctor uses a special lens called a gonioscope to evaluate the drainage structures at the front of the eye. It helps determine whether the angle is open or closed, which is important in classifying the type of glaucoma.
Optical coherence tomography (OCT): OCT uses light waves to create high-resolution cross-sectional images of the optic nerve and the layers of the retina. It can help assess the thickness of the nerve fiber layer and detect any changes or damage caused by glaucoma.
Pachymetry: Pachymetry measures the thickness of the cornea, which can influence intraocular pressure readings. A thin cornea may lead to falsely low pressure readings, while a thick cornea may result in falsely high readings.

Additional factors such as family history, medical history, and overall eye health are also taken into consideration during the diagnosis process.

It’s important to note that glaucoma is a progressive eye disease, and early detection is crucial for effective management and preservation of vision. Regular eye examinations, especially for individuals at higher risk, such as those with a family history of glaucoma or individuals over the age of 40, are recommended to detect and monitor glaucoma.