I have a new spectral-domain optical coherence tomographer (SD-OCT) that I used to perform an optic nerve evaluation on a patient. The test shows a very thin nerve fiber layer (NFL) and ganglion cell layer thinning. The patient has para-nasal visual field defects in both eyes. Her discs look normal, her IOP is 15mm HG OU and there is no family history of glaucoma. Is this low-tension glaucoma?
I started covering optometry way back in 1991. Then, authors had to mail in their articles on floppy discs and we would send them edits on a new high-tech device called a fax machine. That feels like a prehistoric time compared to now. Also, so much has changed clinically since then that it’s practically a brand-new profession. But one thing hasn’t changed: the way scope of practice expansion efforts play out.
It is common to detect retinal neurodegeneration only after extensive RGC death and significant visual loss have already occurred. Given the primacy of RGCs in glaucoma’s story, our research team has been working on a promising new diagnostic approach to improve early diagnosis that detects glaucomatous changes at a cellular level.