Evaluation of Glaucoma
Pachymetry
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NORMAL CENTRAL CORNEAL THICKNESS
IS VARIABLE 500-550 MICRONS
- Thinner cornea (cct < 500 µm) can give falsely low pressure readings
- A thick cornea (>600 µm) can give falsely high pressure readings
Evaluating Optic Disc
Introduction
Glaucoma: Optic Nerve Head Changes
- Increased size of the cup
- Thinning of disc rim
- Progressive loss of neural rim tissue
- Disc hemorrhages
- Loss of nerve fibers
Glaucomatous Cupping
Healthy neuroretinal rim
Healthy, symmetric optic nerves
C:D ratio = 0.3
Thinning neuroretinal rim, elongated cup
- C:D ratio = 0.9
- C:D ratio = 0.7
Extensive glaucomatous damage
Flame-shaped disc hemorrhage
Retinal nerve fibers
Pattern of retinal nerve fibers
Optical nerve imaging: examples of new technologies
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Confocal scanning laser ophthalmoscopy
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Optical coherence tomography
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Scanning laser polarimetry
Visual Field Assessment
Normal visual field
Nasal visual field and midperipheral vision loss
Automated perimetry
Visual Fields in Glaucoma
Electroretinogram ERG
Pattern electroretinogram