Your child’s glaucoma specialist will conduct a thorough examination of your child’s eyes. If your child is cooperative, the tests may be performed in the office. If your child cannot fully cooperate with needed testing, the exams may be performed under anesthesia and immediately followed by appropriate surgical treatment, if necessary.
Measures the eye pressure. Several devices may be used for this test; however, the newest instrument -- the iCare rebound tonometer -- has been extensively studied at the Duke Eye Center for its usefulness in evaluating children with known or suspected glaucoma. Because it does not require an eye drop to numb the eye before taking the eye pressure, this device is well suited for in-office use on infants and children.
Optical Coherence Tomography (OCT)
OCT uses light to create a 3-D image of structures within the eye, including the retina and optic nerve. The images are used to measure the thickness of the nerve fiber layer around the optic nerve so that it can be tracked over time to assess for damage from glaucoma. Since many children cannot cooperate with accurate testing of their peripheral vision, OCT provides a powerful tool for monitoring optic-nerve health in children with known or suspected glaucoma. Handheld OCT recently became available for use in the operating room and may soon prove useful for evaluating optic-nerve health in infants and children too young to have traditional imaging and peripheral-vision testing.
Measures the peripheral vision (also called the visual field) in each eye. During the test, your child looks straight ahead while lights flash at various levels of brightness in their side vision. The test allows doctors to detect defects in the visual field. It is used to diagnose and determine the progression of glaucoma but is only used in older children who can concentrate and whose central vision is good enough to fixate on the central target during testing.
A small contact lens is placed on the surface of the eye to view the outflow pathway (the “angle structures”) of the eye. This test can be done in the office, or during an examination under anesthesia for infants and young children. The detailed structure of the outflow pathway allows your doctor to determine the best surgical treatment for your child's glaucoma.
Sound waves are used to measure the thickness of the cornea and the length of the eye and to create images of the vitreous, the retina, and any glaucoma drainage implants that have been placed in the eye.