glaucoma los angeles

Glaucoma Diagnosis

At the East West Eye Institute we are specialists in the diagnosis and management of all forms of glaucoma.   Because no single test exists that can diagnose glaucoma in all affected individuals, we have a multitude of state of the art advanced diagnostic devices to assist our doctors in accurately assessing your risk of glaucoma. 

Ocular Coherence Tomography (OCT) - This instrument can be thought of as a high-resolution computer generated picture of the back of the eye, namely the optic nerve and retina.  The OCT is used to detect changes in these structures that are caused by glaucoma.  It can often detect these changes at their earliest stages, long before any clinically measurable vision loss occurs.  This test is generally performed once per year, more often if necessary, and both eyes are usually tested in a single office visit.

Humphrey visual field - This instrument measures one’s “side” or “peripheral” vision.  Loss of peripheral vision is asymptomatic and can occur early in the disease process.  Once any vision is lost in glaucoma, it generally can not be recovered.  The purpose of this test is twofold:  First, it serves as a baseline measurement to detect if any peripheral vision loss has occurred prior to an initial evaluation for glaucoma.  Second, it is repeated periodically to see if any progression in the disease process has occurred between visits.  Most commonly, each eye is tested once per year, more often if necessary.

Corneal pachymetry - This important test measures the thickness of the cornea, the clear window that makes up the front surface of the eye.  The thickness of the cornea relates directly to the accuracy of the intraocular pressure measurement.  If one has a thick cornea, the pressure reading taken directly from the machine will be falsely elevated, i.e. it will read higher than it actually is.  For example, if a patient has a thick cornea and the pressure reading from the machine is 22 (normal for most people is generally between 10 to 20), the “true” pressure will be less, maybe 17 or 18, depending on how thick the cornea is.  In this case, what initially looks to be a high pressure, in reality is likely to be a normal pressure.  The converse is also true.  If one has a thin cornea, the intraocular pressure measurement shown by the machine will be less than it actually is.  This test is generally performed once per eye at or around the time of the first visit to calibrate our measurements accordingly.  Without this test, we cannot be sure of the accuracy of the intraocular pressure measurements.

Digital stereoscopic photography - Characteristic changes called “cupping” can be seen in the optic nerve head as the damage from glaucoma progresses.   This cupping usually occurs early in the disease process, well before a patient has noticeable vision loss.  Baseline photographs are an excellent way to document this cupping.  During subsequent visits, the appearance of the optic nerve cupping can be compared to the baseline photographs.  Any increase in cupping is a sign that glaucoma is progressing.  Optic nerve head photos are usually taken every 1 to 5 years, depending on the severity of the disease.

COSMETIC PROCEDURES