Check out these two pictures. Which optic nerve do you think has glaucoma? (hint: the optic nerve is the brighter round part in the back of the eye).
In all seriousness, Normal-tension (NT) Glaucoma is a potential red herring for other more serious eye diseases. We are extremely suspicious for an underlying condition if we see the above nerve on the left plus our patients who meet the following criteria:
- Less than 50 years of age.
- Visual acuity less than 20/40.
- Optic disc pallor is in excess of cupping.
- Vertically aligned visual field defects (glaucomatous field defects tend to align horizontally).
These criteria are assessed at every annual eye exam.
Additionally, we evaluate the patient's history for conditions that often present concomitantly with NT glaucoma, including:
- A history of migraines.
- Sleep apnea.
- Raynaud's phenomenon (a vasospastic condition that results in discoloration of the fingers and toes).
If you suspect that an NT glaucoma patient has a more serious underlying ophthalmic condition, promptly refer the individual for neuroimaging. We are finding that our Digital Retinal Imaging technology is helping us diagnose glaucoma and other diseases sooner before any serious damage occurs.
Show some love for your eyes and see us for your once-a-year eye exam!