The Air Puff – Glaucoma Eye Pressure Test

welcome back to another episode of eye
care in focus where we try to make eye health and vision care more clear for
you today we’re gonna try to figure out why your doctor always does that air
puff machine to you every single time you go into their office our topic for
today is glaucoma we’ll get to the air puff in just a little bit so what is glaucoma glaucoma is a disease of the optic nerve and everybody has kind of heard
that high eye pressure is what causes glaucoma and while it’s not quite that simple in all
cases lowering the eye pressure is the only to treat glaucoma so eye pressure
is a big part of it so what are the symptoms of glaucoma well not a whole
lot at first but closer to the end stages of glaucoma it will eventually
get to the point where blindness starts creeping in from the peripheral vision
working its way in until you have tunnel vision or eventually nothing left in
some cases people will have really really high eye pressure it can cause
pain but for the most part people who have glaucoma have no idea so here’s a
picture of the back of my eye my optic nerves actually look a little bit
suspicious for glaucoma so this is the optic nerve this big circle here when
you see that smaller circle there the more yellow one that’s what we call the
cup everybody has this cup but mine is a little bit larger than what’s considered
normal so this smaller circle is called the cup
because it’s shaped like well a cup it’s just an empty space that goes back into
the optic nerve so the theory is that all this eye pressure building up in
your eye is pushing on that space and doing damage to the nerve fibers that
are on the outside of that cup which is what makes them die off which is what
makes that cup get bigger so here’s a picture of an optic nerve that is
considered more normal here’s the optic nerve and it’s really hard to even see
that little circle because it’s so small sometimes it’s a little bit larger than
that it can be normal but like I said mine is definitely larger than normal
but just because my optic nerve looks suspicious for glaucoma that doesn’t
mean that actually have glaucoma it means that I need to watch it so what we
want to watch for it is we want to make sure that this cup is not getting larger
over time this whole part of the optic nerve is called your nerve fiber layer
all these nerves are coming from the of your eye and traveling out through
the topic nerve kind like the ponytail on the back of a girl’s head so if those
nerve fibers start dying off this empty space the cup in the middle will start
getting bigger but the process of those nerve fibers dying off is the result of
glaucoma so how do we make sure the optic nerve isn’t changing over time
picture this is a good way to do that we can look at pictures from one year to
the next five ten years later also there’s a machine called an Oct an Oct
helps us get a measurement of the optic nerve and of that Cup so if a machine is
doing the measurement it takes a little bit of the guesswork out instead of
human errors going ehh I think that’s changed over time or I think it’s the
same a machine is telling us for sure this is the size of it one time this is
the size of it the next time another way that we can monitor for changes in
glaucoma is to look at a visual field test the visual field test is that one
where you look into this big bowl when these lights pop up all to the outsides
you have to push a button every time you see one of those lights so if we know
that somebody’s visual field is normal one time and we repeated again later on
and they have any part of this that’s showing a visual field defect we can
assume that something has caused that visual field defect these are the
results that we get after that test is finished this is a map of the visual
field the dark spot is a blind spot now that one’s normal because your optic
nerve causes a blind spot everybody has these in the back of the eye so that’s
not there we know you did the test wrong there are no other defects out here that
show us this person has any blind spots so if a dark patch popped up let’s say
off to this side and kind of came in this direction or if kind of the whole
thing was getting dark to the outsides we might want to compare that to
previous visual fields and see if that’s a change
another thing we like to monitor when we’re testing for glaucoma is the eye
pressure there are lots of different ways to do that but most famously people
know about the air puff test and everybody hates it but let me describe
to you the alternative the other way that we check the eye pressure is to put
a yellow eye drop in your eyes and then bring a little blue light and the
microscope over there and actually touch the front part of your
so there are a lot of different things that we have to consider when we’re
trying to diagnose glaucoma factors like corneal thickness age ethnicity
and family history come into play if you have a family history of glaucoma it
puts you at slightly higher risk to develop it yourself so it’s important to
get your eyes checked regularly so how do we treat glaucoma it starts with all
that testing that we talked about earlier but then if we actually diagnose
somebody with glaucoma we usually start them on a regimen of eye drops a lot of
times it just starts with one drop at bedtime people respond differently to
certain types of drops and there are also different reasons that we can’t use
certain drops for each individual patient so we’ll start with one usually
and if that doesn’t work sometimes we have to add in another sometimes even
add in another but if you’ve been put on a few different eye drops for glaucoma
they’re not working a lot of times we’ll send for a surgical evaluation there are
surgeries that can do such as opening up the drainage system with a laser
they can also surgically install a shunt that would move fluid from the inside
part of the eye into a different area they call a bleb so taking some of that
fluid out of the I will lower the pressure there are lots of different
products and procedures coming out for glaucoma all the time so make sure to
ask your doctor about the most recent research so make sure to have your eyes
checked regularly including the air puff machine to make sure that you’ll never
have to worry about glaucoma this has been Eye Care In Focus
I’m Dr. Jordan Netzel see you next time if you have a question or a topic you’d
like us to cover make sure to send us a message on our Roberts Phillpott eye
associates Facebook or Instagram page or leave a comment below

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