Comprehensive Glaucoma Evaluation in Ahmedabad — Puja Eye Hospital

Glaucoma is often called the ‘silent thief of sight’ because it causes irreversible vision loss with little or no warning in its early stages. By the time most patients notice changes in their vision, significant and permanent damage has already occurred.

A comprehensive glaucoma evaluation is the only reliable way to detect glaucoma early — before vision is affected — and to monitor its progression over time. At Puja Eye Hospital, Naranpura, Dr. Puja Sheth conducts thorough, multi-parameter glaucoma assessments using advanced diagnostic technology.

What Is a Comprehensive Glaucoma Evaluation?

A comprehensive glaucoma evaluation is not a single test — it is a structured, multi-step assessment that examines every aspect of the eye relevant to glaucoma diagnosis and progression. It combines clinical examination with advanced imaging and functional testing to build a complete picture of your glaucoma risk and status.

At Puja Eye Hospital, the evaluation includes the following components:

Components of the Evaluation

1. Eye Pressure Testing — Tonometry

Intraocular pressure (IOP) measurement is the most fundamental test in glaucoma care. Elevated eye pressure is the primary risk factor for glaucoma and the main target of all glaucoma treatments.

Tonometry measures the pressure inside the eye using a precise, calibrated instrument. At Puja Eye Hospital, IOP is measured using Goldmann applanation tonometry — the internationally accepted gold standard — which provides the most accurate reading available.

It is important to note that some patients develop glaucoma despite having normal eye pressure (normal-tension glaucoma), and some patients have elevated pressure without any glaucoma damage. This is why pressure measurement alone is never sufficient — it must always be interpreted alongside the other components of the evaluation.

2. Gonioscopy — Angle Examination

Gonioscopy is a specialised examination of the drainage angle of the eye — the area where the iris meets the cornea and where the eye’s fluid (aqueous humour) drains out. This angle is invisible during a routine eye examination and can only be assessed using a gonioscopy lens.

Gonioscopy determines whether the drainage angle is open, narrow, or closed — the critical distinction between open-angle and angle-closure glaucoma. This information directly determines the type of glaucoma you have and the treatment approach required.

Not all eye clinics routinely perform gonioscopy. At Puja Eye Hospital, it is a standard part of every comprehensive glaucoma evaluation.

3. OCT — Optical Coherence Tomography (Zeiss)

OCT is an advanced imaging technology that produces detailed cross-sectional images of the optic nerve and the retinal nerve fibre layer (RNFL) — the layer of nerve fibres that carries visual signals from the eye to the brain.

In glaucoma, these nerve fibres are progressively damaged and lost. OCT can detect this thinning with remarkable precision — often identifying early glaucoma damage years before it becomes visible on standard clinical examination or before any visual symptoms develop.

Puja Eye Hospital uses a Zeiss OCT system — one of the most accurate and widely validated OCT platforms in clinical use worldwide. Serial OCT scans are compared over time to track whether nerve fibre loss is progressing, and at what rate.

4. RNFL Measurement — Optic Nerve Analysis

The RNFL (Retinal Nerve Fibre Layer) measurement is generated as part of the OCT scan. It provides a quantified, normative-database-compared analysis of the thickness of the nerve fibre layer around the optic disc.

RNFL thinning is one of the earliest detectable signs of glaucoma. Tracking RNFL thickness over serial visits allows Dr. Sheth to determine whether glaucoma is stable or progressing — and to adjust treatment accordingly.

5. Pachymetry — Corneal Thickness Measurement

Pachymetry measures the thickness of the cornea — the clear front surface of the eye. Corneal thickness is an important glaucoma risk factor that is often overlooked in routine eye examinations.

A thin cornea is an independent risk factor for glaucoma development and progression. Additionally, corneal thickness affects the accuracy of eye pressure readings — a thin cornea causes the tonometer to underestimate the true pressure, while a thick cornea causes it to overestimate. Pachymetry allows Dr. Sheth to correct the measured IOP for corneal thickness and arrive at a more accurate assessment of the true eye pressure.

Who Should Have a Comprehensive Glaucoma Evaluation?

You should book a glaucoma evaluation if you have any of the following risk factors or concerns:

A family history of glaucoma — first-degree relatives (parents, siblings) of glaucoma patients have a significantly higher risk
Age above 40 years — glaucoma risk increases substantially with age
Elevated eye pressure detected during a routine eye check
Diabetes — diabetic patients have an increased risk of certain types of glaucoma
Short-sightedness (myopia) — high myopia is associated with an increased risk of open-angle glaucoma
Previous eye injury or trauma
Long-term use of steroid eye drops, steroid inhalers, or oral steroids
A history of eye surgery
Any gradual changes in peripheral (side) vision
A cup-to-disc ratio of 0.6 or higher noted on a previous eye examination

How Long Does the Evaluation Take?

A comprehensive glaucoma evaluation at Puja Eye Hospital takes approximately 60 to 90 minutes. Eye drops to dilate the pupils may be required for certain components, particularly for optic nerve assessment. You will be advised at the time of booking whether to arrange transport, as dilating drops temporarily blur vision and affect your ability to drive.

Puja Eye Hospital- Glaucoma Eye Hospital

Protect Your Vision — Book a Glaucoma Evaluation Today

Call or WhatsApp Dr. Puja Sheth: +91 8780012121 Puja Eye Hospital, Naranpura, Ahmedabad | Mon–Sat: 9:30 AM – 4:30 PM

FAQs

Is the evaluation painful?

No. All components of the comprehensive glaucoma evaluation are non-invasive and painless. The gonioscopy lens involves brief contact with the eye surface after anaesthetic drops are applied, which is very well tolerated.

Can I drive after the evaluation?

If dilating drops are used during the evaluation, your vision will be temporarily blurred and you will be sensitive to light for approximately 4 to 6 hours. It is advisable to arrange for someone to drive you home. If you prefer to avoid dilation, please inform the clinic at the time of booking so that the examination can be planned accordingly.

How often should a glaucoma evaluation be repeated?

For patients newly diagnosed with glaucoma, follow-up evaluations are typically scheduled every 3 to 6 months initially. Once the condition is stable and well-controlled, annual evaluations may be sufficient. For high-risk individuals without confirmed glaucoma, annual screening is generally recommended.

Does a normal evaluation mean I do not have glaucoma?

A normal evaluation is very reassuring. However, glaucoma can sometimes develop or progress subtly. If you have significant risk factors, regular follow-up evaluations are recommended even after a normal result, as glaucoma is a lifelong condition that requires periodic monitoring.

Do I need a referral to book an evaluation?

No referral is required. You can book directly by calling or WhatsApp messaging Puja Eye Hospital. Many patients visit Dr. Sheth for a second opinion or as a self-referred patient with concerns about their eye pressure or a family history of glaucoma.