Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Your ophthalmologist performs different tests during an office examination to screen for lens-particle glaucoma. These tests are described below.
The front of your eyes, including your cornea, anterior chamber, iris, and lens, are examined using a special microscope called a slit lamp. During a slit lamp examination, your ophthalmologist can see if any inflammation is present in the anterior chamber and if any lens fragments are visible in the vicinity of the lens capsule or elsewhere inside the eye.
The inside of the eye can also be viewed through a process called indirect ophthalmoscopy. Using this method, particles of the lens cortex or nucleus that became dislocated into the vitreous can be seen by your eye doctor.
Tonometry is a method used to measure the pressure inside the eye. In lens-particle glaucoma, elevated IOP in only one eye is a characteristic finding.
During gonioscopy, the drainage structure in the front portion of your eye is checked. The angle of the eye is formed where the iris and the cornea come together. To view the angle, a special contact lens is placed on the eye. This test is important to determine if the angles are open, narrowed, or closed and to rule out any other conditions that could cause elevated IOP. With lens-particle glaucoma, the anterior chamber angle is open, unless inflammation secondary to the lens particles has been severe enough to cause adhesions within the angle.
Ultrasound testing may be useful in locating and measuring retained lens debris, particularly large nucleus fragments.
Because optic nerve damage is usually a sign of glaucoma development, each optic nerve is examined for any damage or abnormalities. This may require dilation of the pupils to ensure an adequate examination of the optic nerves. Optical coherence tomography (OCT) may be conducted to document the status of your optic nerve and to detect changes over time.