Dr. Rahul Vaswani
Ophthalmology (Eye Care)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have glaucoma. Last week, I had an iris scan (USG). From the iris scan, are you able to diagnose whether it is an open angle, narrow-angle or closed angle? Currently, I am taking Timolol with Latanoprost eye drops.
Hi,
Welcome to icliniq.com.
From the scans (attachment removed to protect patient identity), your angles seem open. But we cannot diagnose glaucoma based on this investigation alone. The list of investigation that you have to get done includes applanation tonometry to check the pressure, Pachymetry, Gonioscopy, Automated fields perimetry, RNFL (retinal nerve fiber layer analysis) OCT (optical coherence tomography). After that only we can reach a conclusion.
Patient's Query
Thank you doctor,
My current pressures are fine. Between 13 to 17 on each eye. That is after using eye drops Timolol and Latanoprost. Before the eye drops, IOP was above 25 mmHg. At one stage, tonometer (non-contact), was at 30+, although when confirmed with contact type, it was around 26. I have done all those tests you indicated. One doctor indicated laser iridotomy. Another said it is an open angle type. I am wondering whether I should consider it urgent to have a laser iridotomy now to prevent an acute attack? Or just leave it for a later time. Since open-angle type does not need laser puncture in the first place.
Hi,
Welcome back to icliniq.com.
Yes, you are right in saying that open angle does not require laser iridotomy. In my opinion, angles are open but since you have such confusion here is what you can do. Have a repeat gonioscopy to establish a diagnosis. Have a Pentacam to assess chamber volume if the value is 110 or less it means iridotomy is required otherwise you are fine.
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Ophthalmology (Eye Care)
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