Testing For Glaucoma

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What Is Glaucoma?

Left untreated glaucoma can cause irreversible vision loss, however early detection and adherence to treatment can halt or significantly slow its progression. The best way to protect your sight is to have a comprehensive eye exam including an optic nerve check which is simple and painless.

During a glaucoma exam your eye health practitioner will:

Measure your eye pressure, also known as intraocular pressure (IOP).
Inspect your eye’s drainage angle.
Examine your optic nerve for damage.
Test your central and peripheral (side) vision.
Take a picture or computer measurement of your optic nerve.
Measure the thickness of your cornea.

It is important to remember that glaucoma cannot be self-detected. Only an optometrist or an ophthalmologist can determine whether you have glaucoma or not.

A ophthalmologist and patient looking at test results on a computer screen. Six coloured icons signify each test for glaucoma

6 Common Tests for Glaucoma

Glaucoma is a complex disease, and no single test can provide enough information to make a diagnosis. The following is a brief overview of the five most common glaucoma tests:

Tonometry (Eye Pressure Test) Show less Show more

Tonometry measures the pressure within the eye. One of the main risk factors for glaucoma is high eye pressure and the best known treatment for glaucoma is lowering the eye pressure. Therefore the accurate measurement of the eye pressure (tonometry) is essential. The Goldman Applanation Tonometer is the most accurate way of measuring the eye pressure. It involves numbing the eye with eye drops first and then the instrument gently contacts the front of the eye to take the measurement.

Gonioscopy (Drainage Angle Outflow) Show less Show more

Gonioscopy is the examination of the drainage angle for the outflow of intraocular fluid. Fluid is constantly being made in the eye and it flows out of the eye at the drainage angle. This test can determine if the high eye pressure is caused by a closed/blocked angle (angle closure glaucoma) or if the angle is open but just not working well enough (open angle glaucoma). This is important because the management of each sub-type is slightly different. The test involves putting a mirrored lens on the surface of the eye after using a numbing drop, almost like wearing a contact lens.

Ophthalmoscopy (Optic Nerve Check) Show less Show more

Ophthalmoscopy is the visual examination of the optic nerve. Since glaucoma is a disease of the optic nerve, this is a key test. Dilating drops are usually given to enlarge the pupil, so that the optic nerve can be more clearly seen. The nerve(s) will be looked at for signs of glaucoma-related nerve cell loss. This can be done using a table top slit lamp or hand held ophthalmoscope. The appearance of the optic nerve can be documented with a drawing, a photo or with an imaging device. This is so any worsening of the nerve appearance can be detected in the future.

Perimetry (Visual Field Test) Show less Show more

Glaucoma initially causes peripheral vision loss that the patient does not notice. This vision loss can be detected with a perimetry test (also known as a visual field test). It involves testing each eye separately with an automated machine that flashes a series of small lights in the periphery to which the patient should react by pressing a button. The perimetry test takes around 3-6 minutes per eye and is repeated 1-2 times a year so that every new test can be compared to the previous ones to look for any worsening.

Optical Coherence Tomography (OCT) Show less Show more

An OCT scan is an important test in diagnosing and monitoring glaucoma. It is used to measure the retinal nerve fibre layers (RNFL) around the optic nerve which is an important marker of early to moderate glaucoma damage. For glaucoma suspects and those at the very early stages of glaucoma, the visual field test may not show any peripheral field damage however, the measurements from the OCT can detect early signs of glaucoma. The OCT measurements can also help monitor any changes and progression with glaucoma. This can help determine the treatment plan.

Pachymetry (Corneal Thickness) Show less Show more

Pachymetry is a test that measures the thickness of the front window of the eye (cornea). The eye is numbed with drops then a contact probe quickly measures the thickness in a few seconds. A very thick or very thin cornea can affect the pressure/tonometry readings and also a very thin cornea increases the risk of developing glaucoma.

How often should I have an eye exam?

Glaucoma Australia recommends all Australians 50 years or older visit an optometrist every 2 years for a comprehensive eye exam, and if you have a family history of glaucoma or are of Asian or African descent we recommend you get your eyes checked every 2 years from the age of 40.

If your family member has advanced glaucoma, it is recommended that you attend regular eye health checks commencing 10 years earlier than the age of diagnosis of your affected relative. For those identified as glaucoma suspects, it will be beneficial to have an eye test every 6 months or as recommended by your eye care professional.

Book an eye exam Photo of an optic nerve showing signs of advanced glaucoma

Read more about this Stages of glaucoma progression

By viewing the images of each stage of glaucoma, we can better understand the progressive loss of the retinal nerve fibre layer (RNFL), and the visual changes associated with this disease.

Learn more Two sisters in their 50s and 60s laughing and smiling at the camera