What is Integrative Testing for Glaucoma?
We differentiate our services from those of others by our focus. Our goal is to slow or reverse the disease process. We can only achieve this goal by understanding the origins of the disease. In the case of glaucoma, we are one of a very small number of practices that integrates the use of next generation functional tests such as VEP and ERG as part of our comprehensive nerve and retinal evaluation. When combined with more traditional tests such as OCT and perimetry, we provide the most comprehensive diagnostic evaluation for glaucoma available. As if this is not enough, we now screen for micronutrient deficiencies. Specifically, we have identified subclinical or low vitamin B 12 levels in about 10% of our glaucoma patients.
Integrative testing for glaucoma includes functional, structural, and systemic testing, which allows Dr. Narain to diagnose and follow the progression of glaucoma and other vision disorders. Vision is the result of electrical signals that travel between the retina and the part of the brain involved with vision (the occipital cortex). Electrophysiology testing checks to see how well the visual nerve pathway is at sending electrical signals needed for vision. These tests measure electrical activity that occurs in your eye when you look at something. Microperimetry is a visual field test used to access central vision and optical topographies evaluates retinal structure.
Integrative testing allows for earlier detection of glaucoma, which allows for earlier treatment and greatly improved outcomes. Functional changes often occur before structural changes in glaucoma and it is important to catch optic nerve dysfunction before the nerve is permanently damaged.
Using these tests, we can diagnose glaucoma before patients have any visual symptoms.
What are the Different Tests?
Functional testing includes:
- Electroretinography (ERG), which measures the retina’s electrical response while you look at flashes of light or different patterns. An ERG test can check for diseases and problems of the retina.
- Visual evoked potential (VEP), which tests the electrical activity in the entire visual pathway. A VEP test can find issues by showing how brain waves respond to certain things you look at during the test.
- Microperimetry (MP), which evaluates macular function and central vision.
Structural testing includes:
- Optical Coherence Tomography (OCT) Nerve or Macula, which measures optic nerve cupping and nerve/macula fiber layer iridocorneal angle.
- Gonioscopy, which measures the iridocorneal angle.
Systemic testing includes:
- Screening for micronutrient deficiencies such as B12 deficiency.
Should I Prepare for Integrative Testing?
You won’t need to do anything in preparation for your test. Follow any instructions that Dr. Narain gives you about what to do before and after testing.
What Can I Expect During Each Test?
During electroretinography (ERG), tiny electrodes are placed on your forehead and on your lower eyelids. The test records the electrical response in your eye as you look at flashes of light or a pattern of images. The test takes about 10 minutes to complete.
During visual evoked potential, a computer records changes in your brain waves while you look at checkered patterns. Electrodes are placed on your forehead, temple, and scalp, near the areas of your brain involved with vision. For several minutes, you will look at repeated patterns that appear in quick flashes on a screen. The test measures the time of response and the brain’s electrical activity.
During microperimetry, a stimulus is shown on an external screen and you are instructed to press a button if you can visualize the stimulus. This test creates a retinal sensitivity map of the quantity of light perceived in specific parts of the retina in patients with central vision loss.
Request an Appointment in San Jose or Gilroy, California
At South Bay Retina, we provide integrative testing for glaucoma and other optic nerve and retinal diseases. To schedule with Dr. Narain, our experienced ophthalmologist and retina specialist, call (408) 294-3534 for our San Jose and Gilroy office. You can also schedule online using the button below.