Should I visit an ophthamologist for further glaucoma tests?

Question

A couple months ago my optometrist said I was borderline after she did the air puff test, but left it at that (she didn't seem too concerned and she told me there are other reasons I might have come up borderline). Since then, I've had several people tell me I should still visit an ophthamologist for further testing. What should I do? There is no history of glaucoma in my family, and I am a 26-year-old, healthy, near-sighted Caucasian female. Thanks!

Answer 1

That test is notoriously inaccurate. You could show a pressure that the books say is normal but can still have glaucoma and be in danger of going blind. You could have the test done ten times in a row and get 10 different readings.

Optometrists are there to measure what glasses you need. They are not trained in diseases of the eyes. You need to go to an ophthalmologist who will look at the shape of your retina where the optic nerve is, looking for the flattening of that cup area that indicates damage from glaucoma. An ophthalmologist can also do field tests to see how much peripheral vision loss you have and recheck again to see if that has worsened.

If you ignore glaucoma you will lose all of your peripheral vision and be unable to drive a car or watch out for traffic when walking across the street.

Answer 2

Having worked for both an Optometrist and Opthalmologist, my opinion is that BOTH are very qualfied to diagnose and treat Glaucoma. Major difference between the two is that the Opthalmologist is able to perform surgery. Optometrists are licensed to administer drops for Glaucoma, infections,and abrasions. They take an addional licensing to be able to legally do this.

FYI:
Scope of practice
Optometrists are the primary health care providers for the eye and visual system. They are not surgeons but may refer patients for surgical care when needed. Optometrists examine, diagnose and medically treat eye diseases, injuries, and disorders of the visual system as well as identify related systemic conditions affecting the eye[s]. Some optometrists specialize in work with the elderly, children, or partially sighted persons who need specailized visual devices. Others develop and implement ways to protect workers eyes from on-the-job strain or injury. Some specialize in contact lenses, sports vision,or vision therapy. A few teach optometry, perform research, and consult. SOURCE: Bureau of Labor Statistics/www.bls.gov


You can of course get a second opinion, if you feel you need that. You could also start getting your pressures checked every 6 months. (many patients do that-it's just an office visit not a full exam) It's all up to what makes you feel more educated and at ease about the situation.

Answer 3

The air puff test only tests inner ocular pressure (IOP) which is a risk factor for glaucoma only. This is also not that accuarate of a test. This alone is not an indicator of glaucoma. Given your age and lack of family history only a high reading would have alarmed her. I wouldn't be concerned. Normal ranges for IOP vary.

If you went to the doctor for your yearly checkup and had borderline high blood pressure, would you then go to a cardiologist for heart disease....most likely not! That is an accurate analogy here.

Answer 4

What re-check period did she recommend?
Did the exam include a peripheral field test?

Your age makes glaucoma unlikely, but not impossible.
The importance of pressures *alone* has dropped considerably in medical evaluation of glaucoma in the last 25 years.

Depending totally on the field findings and optic disc appearance, (which I don't know in your case!)
I would either be unconcerned,
repeat the tonometry at another convenient date,
or recommend a shorter than normal re-check period as a precaution.

At least in the UK borderline raised pressures alone, on one occasion, are absolutely no grounds for referral.
(provided the other tests have been done and are satisfactory, and there is no family history or other pre-disposing factors.)

Optometrist, retired.

Answer 5

Rich Z and Ranger 97, optometrists are more than qualified to diagnose and treat and glaucoma. Please know what you are talking about before posting. The only thing an ophthalmologist is going to differently is surgery if it is needed, which most of the time, it is not.

Answer 6

You should go see the ophthalmologist as soon as possible.The optometrist is not a doctor and is not able to treat a disease. She is not being responsible as long as it is out of her knowledge. All she should do are glass prescriptions.

Answer 7

Smoke more pot, you'll be fine.