Question 1

What does being a glaucoma suspect mean?

Accepted Answer

Being a glaucoma suspect means you do not have glaucoma, but you have one or more features that may indicate the condition. This could be that the state of your optic nerve (which starts at the back of the eye) may indicate glaucoma; your visual fields (side vision) are abnormal; there is raised pressure in your eye (a risk factor for glaucoma); or you have a family history of glaucoma. You may also have a combination of these factors.

Question 2

Is my optic nerve normal or abnormal?

Accepted Answer

The optic nerve can vary a lot in appearance from one person to the next, so it is sometimes difficult to know whether an optic nerve is normal or abnormal. If the appearance of the nerve does not change over time, it is likely to be normal for you. However, if there is a change it may suggest a progressive (worsening) disease like glaucoma.

Question 3

Myopia (short-sightedness)

Accepted Answer

Highly myopic (short-sighted) patients have longer eyeballs than others, and their optic nerves can look like they are damaged when in fact the appearance is normal for their eye.

Question 4

Tilted discs

Accepted Answer

Sometimes the optic nerve enters the back of the eyeball at an angle rather than straight on, so it looks tilted from the top. This can give the impression that the tilted side of the nerve head is thinner than the rest. (The optic nerve head is the beginning of the optic nerve that is visible at the back of the eye.) Although unusual, this is normal for that eye.

Question 5

Asymmetric discs

Accepted Answer

Occasionally patients appear to have a bigger nerve head at the back of one eye compared with the other. This can give the impression that the larger nerve head has fewer nerve fibres than the smaller one, but again this is normal for each eye.

Question 6

Why might my visual fields be abnormal?

Accepted Answer

The visual field test measures how much peripheral (side) vision each eye has. It takes some time to understand and perform properly, and there is usually a learning curve — so performance can improve over time. Factors other than glaucoma can also cause a defect in your visual field, such as your eye prescription, tilted discs, the upper lid coming down during the test, or other eye or optic nerve conditions.

Question 7

What will happen next?

Accepted Answer

We will monitor the appearance of your optic nerves regularly using: examination of your eyes with specialised instruments and lenses; photographs or scans of the nerve at the back of your eyes to help detect any subtle changes; eye pressure checks; and visual field tests to ensure your peripheral vision is not reducing. If there is a detectable change in the appearance of the optic nerve, we will discuss this with you and consider treatment or further observation. If glaucoma is diagnosed, it can be treated with daily eye drops, laser treatment, surgery or a combination of different treatments to reduce the eye pressure.

Tilted discs

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