I was recently working in a glaucoma clinic and a patient had been referred to secondary for a suspect visual fields and family history of glaucoma. All other findings were reported as normal.
They had been seen at a multiple and, knowing that this particular multiple offers optical coherence tomography (OCT) services as an additional service, I asked if they had been offered it. OCT can be used to measure retinal metrics with regards to glaucoma and this information can be very useful in determining if someone does have glaucomatous changes to the eye.
It is particularly advantageous if their visual fields are unreliable. Most OCT devices will have a normative database to show how the individual compares to their peers and some will be able to give the probability of the visual fields loss based on the structural findings. This can be used in conjunction with optic nerve appearance to determine if the patient would benefit from a specialist appointment.
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