My RNFL report shows borderline changes. Do I have glaucoma?

Question

Hi doctor,

My ophthalmologist had detected a suspicion of glaucoma more in my right eye compared to the left eye and have optical nerve cupping of 0.4 in left and 0.6 cupping in the right. I had undergone LASIK surgery before six months. In tonometry, I had IOP around 17 (puff test). My report for RNFL analysis has shown borderline changes.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through attachment (attachment removed to protect patient identity). As you have already said, there are few variations in your OCT (optical coherence tomography) RNFL (retinal nerve fiber layer) test more on the right eye compared to the left. So, you are advised for visual field tests and diurnal variation test. As you have done a suspicious disc with 0.6 and 0.4 CDR (cup to disc ratio) but had normal pressures, so your doctor has asked you to do RNFL test as he suspected an entity in you called normotension glaucoma. The results were shown to be in borderline. Hence, your doctor has advised you to do more tests to know the functional status of your optic nerve. One of them is the visual field test. It detects the amount of the word that is perceived by you at a given instance. The second test is done to identify variations in your intraocular pressure overnight. These are more specific tests for glaucoma and can help to monitor your condition better. There are chances to show few abnormalities in these two tests apart from RNFL. You still need six more months to monitor and repeat testing before you get started with eyedrops for your condition. Normotension glaucoma is a chronic and progressive disease. Its diagnosis and monitoring need accurate documentation of your optic nerve function over a prolonged period. Hence, repeat testing every six months.