Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 05/05/21 9:16 AM
The world needs more wholesome headlines, so I made this one up to do my part. Because this headline could (and should!) show up any given day, and the world would feel a bit brighter knowing good things are happening. Glaucoma has been a cause of irreversible vision loss for as long as humans have been around. And yet, we live in a time where it is preventable and treatable.
The reason glaucoma is so sinister isn’t because it’s so difficult to diagnose or treat. It’s because people usually don’t find out they’re at risk until it’s been around for a long time. Sometimes that’s because they didn’t get annual eye exams. But the bigger tragedy is when they did get eye exams, but the glaucoma risk flew under the radar and was never mentioned.
How does that happen? There are two main reasons. One, the testing for it is either non-existent or subpar. Two, there’s no plan for follow up testing or treatment when early signs are detected. Let’s tackle them one by one.
First off, some eye exams just don’t involve an eye pressure check. It’s crazy. It would be like going to the doctor for a physical and they skip checking blood pressure. Sometimes, however, there is an eye pressure check with a device called a “pneumatic tonometer.” It is known — and loathed — as the “puff of air” test. Gosh I hated that thing when I was a kid.
It turns out, the pneumatic tonometer and its puff of air aren’t the best way to check eye pressure. There are methods (that are incidentally much less annoying) that give more accurate data about your eye pressure. Dr. MacDonald (I’m a big fan of hers and so grateful to work with her) uses these more accurate methods. In order to allay suspicion of hand waving about vague, fancy equipment, I’ll mention the Goldmann tonometer specifically. It’s the gold standard (no pun intended, honestly) for intraocular pressure measurement.
Secondly, follow up testing involves visual field testing and/or a 3D scan — called an OCT — of the thickness of your nerve fiber layer (it’s the part of the retina damaged/decreased in glaucoma). Without access to these tests, it’s hard to know if there are changes that need to be addressed. Intraocular pressure checks remain important, but these follow up tests are invaluable for monitoring progression.
If you’re looking for someone wonderful to check for or monitor glaucoma, I’d suggest Dr. MacDonald. I’m biased, but in this case, I think that’s a good thing because I work with her every day. So I’m bound to be biased one way or the other, and I am biased very much towards the amazing care she provides. She’s the source of so very many wholesome headlines at Hunter Vision.