Tools ODs can utilize to diagnose, treat glaucoma
New York—ODs must have the right tools in their toolboxes when treating glaucoma correctly, says Optometry Times board member Michael Chaglasian, OD, FAAO, at Vision Expo East in New York.
“You always want to have the right tool to do your job correctly,” he says. “With new tools and treatments available, ODs are in a great position moving forward.”
Dr. Chaglasian says ODs should be utilizing five tools in their treatment of glaucoma:
• Risk Calculator for Ocular hypertension— Free
• Risk factor considerations for Corneal hysteresis— New
• Optical coherence tomography (OCT) imaging for retinal nerve fiber layer (RNFL) and macular scans— Improved
• Central 10-2 testing—Sometimes
• Progression analysis—Essential
Treating ocular hypertension
Intraocular pressure (IOP) greater than 21 mm Hg in one or both eyes, as measured by applanation tonometry on two or more occasions, is the main risk when treating ocular hypertension in glaucoma patients, says Dr. Chaglasian.
“You must review the patient’s overall risk before treating ocular hypertension,” he says. “The Humphrey Matrix Visual Field (VF) is a great screening device and a great place to start screening glaucoma patients.”
The Humphrey Matrix VF isn’t very consistent, he says, and following patients over time is the best method.
“Personally, I use the HFA 24-2 VF,” he says. “I choose the best strategy based on the patient and his needs.”
Dr. Chaglasian says a great free tool ODs should use is the Ocular Hypertension Treatment Study (OHTS) risk calculator, which is available online.
“You can use the OHTS risk calculator online to input your patients’ information to get the their estimated chance of developing glaucoma in the next five years,” he says. “But if cornea is thin due to LASIK, you can’t use this tool. This is to be used only when evaluating untreated corneas.”
Related: 6 OCT pitfalls to avoid