Glaucoma Associates of Texas

Glaucoma Eye Doctor, Specialty Ophthalmologists

Dallas214-360-0000 • Plano972-612-9522 • Fort Worth817-923-2000
Rockwall469-769-1606 • Sherman214-360-0000
Southlake 214-360-0000

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  • Home
  • About Us
    • Michelle R. Butler, MD
    • Lauren S. Dhar, MD
    • Matthew E. Emanuel, MD
    • Ronald L. Fellman, MD
    • David G. Godfrey, MD
    • Davinder S. Grover, MD MPH
    • Helen L. Kornmann, MD, PhD
    • Oluwatosin U. Smith, MD
  • Our Foundation
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  • Contact us
    • Dallas Office
    • Fort Worth Office
    • Plano Office
    • Rockwall Office
    • Sherman Office
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  • Glaucoma
    • What is Glaucoma?
    • Types of Glaucoma
    • Childhood (Congenital) Glaucoma
    • Exercise and Glaucoma
    • Living with and Managing Glaucoma
    • Light Sensitivity and Glare with Glaucoma
    • Low Vision Due to Glaucoma
    • Nutrition, Lifestyle, and Glaucoma
    • Glaucoma FAQs & Definitions
  • Diagnosis & Testing
    • Diagnosis and Testing
    • Nerve Fiber Analysis
    • Gonioscopy
    • Visual Field Test
  • Glaucoma Treatments
    • Medical Treatment
      • Glaucoma Medications
      • How to Use Eye Drops
      • Compliance with Glaucoma Treatment
    • Laser Treatment
      • Types of Glaucoma Lasers
      • Micropulse Laser
      • Laser Iridotomy
      • Selective Laser Trabeculoplasty
      • Diode Cyclophotocoagulation (CPC)
  • Glaucoma Surgery
    • Types of Glaucoma Surgery
    • Canaloplasty Glaucoma Surgery
    • Endocyclophotocoagulation (ECP)
    • GATT Procedure
    • Glaucoma Drainage Implant Surgery
    • Glaucoma Filtration Surgery (Trabeculectomy)
    • Hydrus® Microstent
    • iStent® Trabecular Micro-bypass
    • Trabectome® Minimally-invasive Glaucoma Surgery
  • Cataracts and Glaucoma
    • Cataract Surgery
    • Cataract Surgery and Glaucoma
  • Research

Glaucoma Diagnosis and Testing

Diagnosing glaucoma is accomplished by examining the optic nerve and its ability to transmit the visual message to the brain. By determining whether or not the optic nerve has been damaged and whether the damage is getting worse, your eye doctor can diagnose glaucoma or determine the stability of disease. Various tools, techniques, and instruments will be used by your ophthalmologist to aid in your care.cupping optic nerve

Optic Nerve Examination for Glaucoma

The optic nerve can be readily examined in clinic using an instrument called an ophthalmoscope. The optic nerve exits through the back of the eye. The nerve is made up of more than one-million individual nerve fibers which originate in nerve cells located in the retina (the light-sensitive film coating the inside of the eye) and travel to various places within the brain. When looking into the eye, the optic nerve is seen end on (optic nerve head), and the nerve fibers are faintly seen to fan out onto the retina.

optic nerve cupping
Moderate Glaucomatous Optic Nerve Changes
In the normal state, the optic nerve head looks much like a doughnut, with the outer ring consisting of the nerve tissue. The hole (called the optic cup) is the empty space within the central nerve head which remains after the nerve fibers fan out into the retina. In glaucoma, the nerve fibers are damaged and erode away, leaving a larger cup (or hole of the doughnut).

As shown in the optic nerve photograph, a normal optic nerve head has a thick outer ring of nerve tissue with a small optic “cup” centrally. In the glaucomatous optic nerve, the outer ring is thin and the “cup” is larger, corresponding to the loss of nerve fibers. Although many different diseases affect the optic nerve, the damage from glaucoma has a characteristic appearance that permits your ophthalmologist to recognize whether glaucoma is present.

Fundus Photography

Fundus photographs (seen above) are performed to aid in following a patient suspicious for glaucoma or those patients with actual glaucoma. By photographing the optic nerve at a particular point in time, doctors can compare future examinations to the photographs taken previously. optic nerve cuppingThis comparison is invaluable in determining optic nerve progression (i.e. worsening of optic nerve cupping) and deciding on medical and surgical therapy for glaucoma.Advanced Glaucomatous Optic Nerve Changes

Optic Nerve Changes in Glaucoma

Fundus photographs are performed to aid in following a patient suspicious for glaucoma or those patients with actual glaucoma. By photographing the optic nerve at a particular point in time, doctors can compare future examinations to the photographs taken previously. This comparison is invaluable in determining optic nerve progression and deciding on medical and surgical therapy for glaucoma.

gonioscopesGonioscopy

Gonioscopy is the use of a goniolens and a slit lamp or operating microscope to view the anatomical angle formed between the eye's cornea and iris. Read more about direct and indirect gonioscopy.

Optic Nerve Fiber Analysis

The optic nerve is composed of over one-million individual nerve fibers/axons. Since the axons of nerves cannot be measured accurately in a live eye, indirect measures of axons (axon “counting”) must be used. Optical coherence tomography (OCT), GDx Analyzer (short for Glaucoma Diagnosis Analyzer), and the Heidelberg Retinal Tomography (HRT) are currently used in clinical practice. Currently, OCT is the most popular technology used by glaucoma specialists for optic nerve fiber analysis. Both OCT and GDx are available at Glaucoma Associates of Texas.

Visual Field Testing for Glaucomaglaucoma and the visual field test

Perhaps the most important tool used to assess optic nerve function, determine whether glaucoma is present, and the status of glaucoma is the visual field test. This test measures how well the optic nerve functions in carrying visual information to the brain. Visual field tests measure the ability of the patient to see light at various points within the retina. Read more about Visual Fields.

Most patients dislike having their visual field tested as the test may be long, tiring, and boring. It is not uncommon to feel that you have performed poorly on a visual field test. Modern visual field machines continue testing each spot measured until the patient misses, in order to determine the dimmest light detectable. Therefore, missed lights may be perfectly normal and should not cause one to be upset.

Please contact the Glaucoma Associates of Texas if you have questions about the treament for glaucoma.

Sherman Office Now Open

Glaucoma Associates of Texas (GAT) would like to welcome you to our new GAT Sherman Office located in Sherman, Texas. We are excited to announce that this is our fifth office in the Dallas-Fort Worth metropolitan area. Our goal is to bring glaucoma specialists closer to your area.

Our Mission

Glaucoma Associates of Texas, Dallas, Plano, Fort Worth and Rockwall

The doctors at Glaucoma Associates of Texas (GAT) are ophthalmologists specializing in the medical, laser, and surgical treatment of glaucoma and cataracts. Each of our physicians has completed a clinical glaucoma fellowship, gaining extensive … Glaucoma Specialists

Our Video Gallery

GATT (Gonioscopy Assisted Transluminal Trabeculectomy)

Welcome to the Glaucoma Photo Gallery and Video Gallery for Glaucoma Associates of Texas! Glaucoma Video Gallery In our first video, Dr. Davinder Grover is interviewed by Cheryl Guttman Krader of Ophthalmology Times. The article about GATT … Video Gallery

Our Charity – Cure Glaucoma

cure glaucoma fund

Glaucoma Associates of Texas   Cure Glaucoma, a charitable foundation, was established in 2014 by ophthalmologists at Glaucoma Associates of … Cure Glaucoma

Archives

Latest GAT News

What’s the Right Surgery for You?

December 10, 2017 By Matthew Emanuel, MD

Click Here to watch Dr. Davinder Grover discuss how glaucoma-trained … [Read More...]

Make the Most of Your Visit

December 2, 2017 By Matthew Emanuel, MD

Click Here to see Dr. Tosin Smith's recent interview on 7 Ways to Make the … [Read More...]

Living With Glaucoma

  • Living with and Managing Glaucoma
  • Low Vision Due to Glaucoma
  • Light Sensitivity and Glare with Glaucoma
  • Nutrition, Lifestyle, and Glaucoma
  • Exercise and Glaucoma
  • Cure Glaucoma Charity

GAT Dallas Office

GAT Plano Office

GAT Fort Worth Office

GAT Rockwall Office

GAT Sherman Office

GAT Southlake Office

5 Office Locations

Dallas Office 214-360-0000
10740 N Central Expressway, Suite 300
Dallas, Texas 75231

Plano Office 972-612-9522
6000 W.Spring Creek Pkwy, Suite 110
Plano, TX 75024

Fort Worth Office 817-923-2000
417 W Magnolia Avenue
Fort Worth, Texas 76104

Rockwall Office 469-769-1606
810 Rockwall Pkwy, #1010
Rockwall, Texas 75032

Sherman Office 214-360-0000
715 E. Taylor Street
Taylor Plaza, Suite 100
Sherman, TX 75090

Southlake Office 214-360-0000
305 Morrison Park Drive
Southlake, Texas 76092

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