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Working in other hospital eye clinics also means that many of the urgent care optometrists are able to bring with them an additional skill set to perform further tasks such as gonioscopy, scleral indentation, confocal microscopy, naso-lacrimal duct syringing and suture removal.
In PPP 2016 , POAG is defined as 'a chronic and progressive optic neuropathy suffered by adults characterized by an acquired atrophy of the optic nerve and a loss of RGCs and their axons and is associated with an open angle by gonioscopy.'[9] PPP 2016 defines a POAG suspect as an individual with clinical findings and/or a constellation of risk factors that indicate an increased likelihood of developing POAG.
Pre-IVTA assessment of patients included detailed medical history with the assessment of best corrected visual acuity (BCVA), biomicroscopic examination of anterior segment with double mirror Goldmann lens gonioscopy and dilated fundus examination with 90 diopter volk lens and indirect ophthalmoscope.
These include a visual-field test that checks peripheral vision, tonometry, which measures eye pressure, gonioscopy, which assesses the angle where eye fluid exists, and a pachymetry test that assesses the thickness of the cornea.
Various methods such as gonioscopy, slit beam on slit lamp examination, IOL master, ultrasound biomicroscopy (UBM), and anterior segment optical coheherence tomography (AS-OCT) can be used to analyze the anterior chamber angle7,10,11.
'My ophthalmologist performed an examination on me which he called Gonioscopy. He said it was to determine if my eyes were open or close,' he said.
Gonioscopy revealed appositional closure of the anterior chamber angle (grade 2, according to the Shaffer classification system, and (A)B20b2+, according to the Spaeth classification system).
For example, gonioscopy examination is the current gold standard for the detection of PACD [10], and is not so suitable for case-finding or large-scale population screening; Van Herick's method has been used as a substitutive assessment method of gonioscopy [11, 12], screening results of which may vary from one ophthalmologist to another [13].
A standardized ophthalmic examination was performed in all the participating patients that included measurement of intraocular pressure (IOP) by Goldmann applanation tonometry mounted at the slit lamp, examination of anterior chamber angles by gonioscopy, dilated pupil examination of the lens and fundus, and visual field testing by Humphrey automated field analyzer.
All patients underwent complete ophthalmological examination including best corrected visual acuity (BCVA), Goldmann applanation tonometry, slit lamp biomicroscopy of the anterior eye segment, gonioscopy, binocular indirect slit lamp funduscopy for evaluation of ONH after 0.5% tropicamide mydriasis, visual field (VF) testing, and OCT.