Prompt Recognition and Treatment of Glaucoma Progression

Prompt recognition of glaucoma progression is crucial for preserving vision. A recent study from Massachusetts Eye and Ear found that structural and functional tests for detecting glaucoma progression rarely show changes at the same visit. Both Optical Coherence Tomography (OCT) structural parameters, such as Retinal Nerve Fiber Layer (RNFL) thickness and minimum distance band rim thickness, and Humphrey Visual Field (HVF) functional parameters were assessed. The study revealed that only 5% of eyes showed progression in both tests simultaneously.

Key Findings

Over a five-year period, it was rare for all four tests—optic nerve head assessment, visual fields, RNFL thickness, and Bruch’s Membrane Opening (BMO) minimum rim width—to show progression (only 6.5% of eyes). Instead, progression was usually detected by just one or two tests.

The study involved 124 open-angle glaucoma patients, each undergoing a full dilated eye exam, disc photography, HVF testing, 2D OCT RNFL thickness measurements, and a 3D OCT neuroretinal rim measurement called minimum distance band. By the end of the study, 75% of eyes showed glaucoma progression by at least one of the tests.

For more detailed information, you can read the original Massachusetts study here .

Clinical Implications

The researchers suggested structural tests might better detect progression in early-stage glaucoma patients, while functional HVF testing may be more effective in advanced cases. They recommend using all available structural and functional tests to determine glaucoma progression and not waiting for all tests to show changes before escalating treatment.

Expert Insight

Dr. Benjamin Ticho of Ticho Eye Associates emphasizes the importance of using advanced technology in glaucoma management: "At Ticho Eye Associates, we use a state-of-the-art OCT machine to measure the thickness of the optic nerve fiber layer, which is basically a way of counting how many functional nerve cells are left. This is an objective method to find glaucoma and detect any progression over time." Dr. Ticho adds, "The objective findings from the OCT machine can be matched to the more subjective visual field test, which aims to find the dimmest light that a patient can detect, both in the center and peripheral field."

Vigilant Glaucoma Detection at Ticho Eye Associates

At Ticho Eye Associates, we are vigilant in detecting glaucoma and glaucoma progression using the most important tests mentioned above: dilated eye exams, photography, visual field testing, and OCT measurements. Additionally, corneal thickness measurements and gonioscopy are crucial data points in our comprehensive glaucoma evaluations. These thorough assessments help us provide the best possible care and management for our patients.

The Importance of Early Detection

Glaucoma is often a silent disease, meaning patients usually don't experience noticeable vision loss until the disease has progressed significantly. This makes early detection and regular follow-up crucial for preventing severe vision impairment. Regular eye exams and the use of advanced diagnostic tools are key to monitoring and managing glaucoma effectively.

Take Charge of Your Eye Health

At Ticho Eye Associates, we are dedicated to providing comprehensive eye care using the latest technology. Our offices in Chicago Ridge, Tinley Park, IL, and Munster, IN, are equipped with cutting-edge OCT and OCT-A machines to ensure thorough evaluations for our glaucoma patients. Call 708-873-0088 to schedule your appointment today.

Stay proactive about your eye health and visit Ticho Eye Associates for regular eye exams to monitor and manage glaucoma effectively.