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Can an Optometrist Diagnose Glaucoma?

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Optometrists go through significant training to become experts on eyes and eye-related issues. They are trained and qualified to diagnose many eye conditions or diseases, glaucoma included. In addition to diagnosing, they can also treat many of these same diseases. If they can’t perform the treatment, they can refer their patients to other doctors with specific qualifications.

The thing about many of these diseases is that a lot of them have little to no symptoms in their early stages. Early diagnosis and treatment are typically critical in minimizing damage. For example, glaucoma is often undetected until a risk of impairment like vision loss or blindness is imminent.

This is why it’s so important to be diligent in getting comprehensive eye examinations as recommended by your optometrist. The eye doctor can consider all of your eye health factors when making the recommendation on exam frequency.

What is Glaucoma?

Glaucoma is an umbrella term for several types of eye disease that cause vision loss or even blindness. Optic nerve damage is the primary cause of vision issues, and typically that damage is caused by abnormal eye pressure.

While the disease is typically more common in older adults, it can strike at any age. One of the biggest problems with glaucoma is that it often develops with little to no symptoms. The changes can be so minimal that you won’t notice them until the disease has developed into the later stages, which could potentially require emergency treatment.

Eye examinations by an eye doctor are the best way—and the only way in most cases—to diagnose the disease early. The benefit of early diagnosis is the prevention of permanent damage from the disease.

Types of Glaucoma

Open-angle and closed-angle glaucoma are the two common forms of glaucoma. However, there are a couple other types as well:

  • Open-angle: This type of glaucoma is the most common form. According to the National Eye Institute, 9 out of 10 people who develop glaucoma get open-angle glaucoma. Besides the pressure causing nerve damage, researchers don’t know what causes this glaucoma. It typically doesn’t present symptoms until its late development, when it begins affecting the vision. 
  • Closed-angle: A less common but more severe type of the disease is closed-angle glaucoma, also known as acute glaucoma. This form is typically a medical emergency. With this type of glaucoma, the outer edge of your iris prevents fluid drainage from the front of your eye. The pressure builds up very quickly and can result in blindness in only a few days if left untreated.
  • Normal-tension: Researchers are still unsure what causes normal-tension glaucoma because it results in optic nerve damage without abnormal eye pressure. However, even though the pressure is normal, pressure-lowering treatments still seem effective.
  • Pigmentary: The iris contains color pigments. Occasionally these pigments can break apart, and tiny pieces get stuck in the eye’s drainage ducts. If these cause a clog that prevents fluid from draining, this is called pigmentary glaucoma.
  • Congenital: As mentioned, glaucoma is typically an age-related condition. However, there are times when a child is born with the disease or develops it early in life. This is called congenital or pediatric glaucoma. As long as it’s treated promptly. There is little risk for permanent damage.
an optometrist looks into a mans eye with a light to diagnose glaucoma

How Does an Optometrist Diagnose Glaucoma?

During your comprehensive eye exam, the eye doctor will typically do several tests to help diagnose glaucoma. This tells them how much (if any) damage has been done by the disease.

Here are several tests that you can expect from the optometrist:

  • Eye pressure: A small burst of air on the eye is used to determine the internal pressure for this test. It can be a bit of a shock when the air contacts your eye, but there is rarely any discomfort.
  • Field of vision: Also known as perimetry, your eye doctor tests your entire field of vision to see if you have any vision loss beginning due to the early development of glaucoma.
  • Eye Dilation: The optometrist may use dilating eye drops to get a good view of your optic nerve. The dilation enables them to use a special instrument to get a magnified view of the nerve.
  • Corneal thickness: A thin cornea has been linked to an increased risk of developing glaucoma, so your eye doctor will likely check your corneal thickness with a pachymetry test.

Glaucoma Treatment

Unfortunately, once the damage is done by glaucoma, there is no way to reverse it. However, once diagnosed, there are several treatment options to slow or stop its progression:

  • Prescription eye drops: There are several drops your eye doctor may prescribe. They all do essentially the same thing—reduce your eye pressure—but in different ways. This is often the first form of treatment.
  • Surgery: There are several surgical options available. Laser trabeculoplasty, which clears the clogged channels in your eye’s trabecular meshwork, is one. Another one is a filtering surgery where the eye doctor performs a trabeculectomy which is essentially the removal of part of the trabecular meshwork if it’s clogged beyond repair.

Earlier Diagnosis Is Better

After discussing this disease, it’s clear that the earlier it’s diagnosed, the better your chances of minimizing any long-term damage. Staying up-to-date on your recommended eye exams is the best way to prevent permanent eye and vision damage. If you have any questions or want to book an eye exam, give our office a shout. The helpful and knowledgeable staff at the Eye Care Center of Colorado Springs is happy to help you.

Written by Dr. Sara Johnson

Dr. Sara Whitney graduated with a B.S. in Biochemistry from Rockford College in Rockford, IL and received her Doctor of Optometry degree from Southern College of Optometry in Memphis, TN. As an optometry student, Dr. Whitney completed a primary care externship in Wilmington, NC, and a hospital-based rotation at the Naval Health Clinic of Corpus Christi in Corpus Christi, TX. Dr. Whitney has cared for patients as an optometrist in the Colorado Springs area since May of 2009. She has experience in family eye care, including pediatric eye examination, adult eye care, treatment and management of ocular disease, contact lens fitting, and eye surgery co-management. Colorado State licensed and certified in ocular pharmaceutical agents, Dr. Whitney’s training and experience allow her to diagnose, treat, and manage or co-manage all eye conditions. Professional memberships include the American Optometric Association, Colorado Optometric Association, and Southern Colorado Optometric Society.
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