People with the most common type of glaucoma, are usually unaware of the disease until advanced and serious vision loss occurs. Once glaucoma damages the sensitive fibers of the optic nerve, the damage cannot be reversed.
It is important for everyone to have regular eye examinations, especially after age 35. Early detection and treatment is the only way known to prevent vision loss and blindness from glaucoma.
Dr. Nepple utilizes very recent developments in technology to detect, monitor and treat glaucoma. This technology includes methods to asses the many eye structures related to pressure in the eye and the absolutely critical assessment of the transparent nerve fibers of the eye which are destroyed in glaucoma. These methods include measurement of intraocular pressure and threshold visual fields.
Nerve Fiber Analysis
Glaucoma causes loss of nerve fibers leading to vision loss. Because the nerve fibers are at the back of
the eye and are transparent, the nerve fiber layer has traditionally been examined using indirect methods. These methods include examining the appearance of the structure of the optic nerve where it enters at the back of the eye when the examining physician looks in the eye or by measuring a patient’s subjective response to presentation of spots of light, called a visual field. Visual fields remain a “gold standard” to determine and measure progression of glaucoma nerve fiber damage. Unfortunately, up to 2/3 of the nerve fibers may be lost before visual fields may detect nerve fiber damage. Similarly, there may be extensive vision loss before structural damage to the optic nerve is detectable by the doctor examining the back of the eye.
Our practice utilizes the GDx scanning laser, a diagnostic test taking only a few minutes to directly measure the thickness of the critical transparent nerve fiber layer at the back of the eye. The nerve fiber layer may then be monitored with subsequent laser scans to determine if treatment is adequate. This laser scanning is covered by Medicare and almost all insurance plans.
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