|
Glaucoma Diagnostic Technology and Treatment
Humphrey Field Analyzer

Visual field testing is an important tool in the diagnosis and management of Glaucoma.
It is used to confirm that Glaucoma:
- Has affected the visual function.
- To evaluate the severity of the disease.
- Monitor progression of the disease.
The Humphrey Field Analyzer is a wheelchair accessible, diagnostic tool used to examine a patient's visual field. It is the recognized standard of care for early diagnosis and management of ocular diseases resulting in visual field loss.
Why we use the Humphrey Field Analyzer
- The Humphrey Field Analyzer has been shown to be extremely accurate.
- Early Glaucoma Detection: this technology has been shown to provide earlier detection of vision loss due to glaucoma.
- The Humphrey Field Analyzer measures visual fields in as little as two minutes.
Peridata
This specialized software allows us to statistically interpret data from the visual field analyzer.
Visual Field Testing and analysis with PERIDATA software allows Dr. Benjamin to utilize unique statistical methods for analyzing the visual field performance in patients with glaucoma.
The advantages of Peridata are:
- Transmission of data from the perimeter to the program PeriData
- Visualization by informative graphics and analysis – Which helps patients understanding of their diagnosis, treatment and outcome.
- Integration into electronical medical records
- Colored maps helps with defect recognition.
- Intelligent statistical analysis helps us to distinguish normal and pathological visual fields, stable courses and negative trends.
The Ocular Blood Flow Analyzer

Ocular blood flow analysis records valuable information about the dynamics of the eye’s vascular network. With this data, we can detect new cases earlier and improve our ability to monitor and manage our current glaucoma patients.
Why we use the Ocular Blood Flow Analyzer
- The OBFA assists in the management and detection of other circulatory abnormalities involving diabetes, retinal and carotid disorders.
- Measures ocular blood flow - as well as intraocular pressure - giving a measurable indication of the vascular health of the eye and is helpful with fitting contact lenses and calculating intraocular lens power for cataract surgery.
- Allows us to evaluate your ocular blood flow and thus predict your lifetime risk of developing glaucoma.
- Fast and comprehensive, the Ocular Blood Flow Analyzer provides highly accurate and sensitive measurements.
The Heidelberg Retina Tomograph (HRT).

The Heidelberg Retina Tomograph is an advanced diagnostic tool that can detect glaucoma at its earliest stages - up to 8 years earlier than fields or photos.
Why we use the Heidelberg Retina Tomograph:
- Study results have confirmed the HRT provides consistent data leading to precise diagnosis of glaucoma.
- HRT not only identifies those patients at high risk for developing glaucoma; it can also identify those at low risk with a greater than 90% accuracy at initial assessment.
- The HRT can accurately differentiate between normal eyes and early glaucoma indication - before any vision loss has occurred.
- The three-dimensional analysis by laser scanning tomography has been shown to be superior to all other imaging technologies.
- Because of its advantages, this technology is now generally accepted and used to provide the best service possible for glaucoma patients and patients at risk.
- The HRT uses a special laser to take 3-dimensional photographs of the optic nerve and surrounding retina.
HOW IT WORKS
- This laser, which is not powerful enough to harm the eye, is first focused on the surface of the optic nerve and captures that image.
- Then it is focused on the layer just below the surface and captures that image. The HRT continues to take images of deeper and deeper layers until the desired depth has been reached. Finally, the instrument takes all these pictures of the layers and puts them together to form a 3-dimentional image of the entire optic nerve.
SLT LASER for Glaucoma
Our in-office Lumenis SLT (Selective Laser Trabeculoplasty) laser can help rid glaucoma patients of their dependence on a strict eye drop regimen by reducing their ocular pressure.
SLT is a safe and simple in-office laser treatment that effectively reduces the pressure in the eye for most patients with glaucoma.
SLT does not rely on medicines, instead, it uses an advanced laser system to target only specific cells of the eye-those containing melanin, a natural pigment. This allows for only these cells to be affected, leaving surrounding tissue intact. As a result, your body's own healing response helps lower the pressure in your eye.
Why we use the Lumenis SLT laser
- SLT is not associated with systemic side effects or the compliance and cost issues of medications.
- SLT utilizes selective photothermolysis to target only specific cells, leaving the surrounding tissue intact.
- SLT stimulates the body's natural mechanisms to enhance outflow of the fluid in your eye.
- SLT therapy is reimbursed by Medicare and many other insurance providers, which minimizes your out-of-pocket expenses.
Yag Laser
The YAG laser is used for a simple procedure called YAG laser capsulotomy used for post cataract patients as well as for Laser Peripheral Iridotomy (LPI) procedure for glaucoma patients.
The modern technique of cataract surgery involves removing the eye’s natural cloudy lens, while leaving the clear outer membrane (called the capsule) to hold the new intraocular lens in place. This capsule has cells on it which will, in some cases, continue to produce lens fibers. These fibers form little beads on the lens capsule, forming a secondary membrane. When these pearls accumulate in the pupil, they can cause a blurring of vision similar to that which one experiences with a cataract. Some patients may also experience glare problems when driving at night. This condition is called posterior capsular haze and occurs in approximately 30-40% of post-cataract patients. It can also appear at any time after surgery, even as much as five or more years later.
During the procedure, called YAG Laser Capsulotomy, a special laser is used to remove these lens fibers. There is no pain involved in this procedure and patients can resume their normal activities immediately. The patient will usually notice an improvement as soon as the pupil, which is dilated, goes back to its normal size.

Laser Peripheral Iridotomy (LPI)
The YAG laser is also used to perform LPI or Laser Peripheral Iridotomy, a procedure for narrow-angle glaucoma.
Narrow-angle glaucoma occurs when the angle between the iris and the cornea in the eye is too small. This causes the iris to block fluid drainage, increasing inner eye pressure.
LPI makes a small hole in the iris, allowing it to fall back from the fluid channel and helping the fluid drain out of the eye. The laser procedure itself causes little sensation. Side effects, if any, may include transient blurring of vision, mild inflammation, temporary elevation of IOP and, less commonly, minimal bleeding at the treatment site. Eye drops are used immediately prior to treatment and for several days thereafter to control inflammation and minimize IOP rise. The small potential for side effects of laser treatment is far outweighed by the serious consequence of angle closure glaucoma if narrow anterior chamber angles are left untreated.
|
Laser Peripheral Iridotomy |
Why we use the YAG Laser
- YAG procedure is completely painless.
- No anesthesia is required.
- Does not require any preoperative tests.
- Does not need an operating room.
- Takes less than 5 minutes.
- Does not have any postoperative restrictions.

Endo-optiks / ECP laser
Endoscopic Cyclo Photocoagulation or ECP, is an exciting new development in the management of most types of glaucoma.
ECP is performed on an outpatient basis. The ECP procedure consists of using laser light to cauterize part of the ciliary body, which results in less fluid and lower intra-ocular pressure. This reduces fluid production that in turn, reduces intra-ocular pressure.
Endoscopic CycloPhotocoagulation (ECP) is often performed on patients at the time of cataract surgery. It can also be performed on those patients who had SLT procedures, glaucoma filtration surgery, or other surgical procedures that were not successful at controlling intra-ocular pressure.
How it is performed
Endoscopic Cyclo Photocoagulation (ECP) is a surgical approach to glaucoma management that employs light endoscopy and visualizedlaser application. The ciliary body (which produces aqueous humour) is viewed by the surgeon, through the endoscope in real time. The target tissues are easily and accurately identified utilizing endoscopy. This allows discrete treatment of the targeted ciliary processes with clear laser ablation and minimized trauma to peripheral (non targeted) tissues.
|