Vision Care Specialists

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Nerve Fiber Analyzer

Pepose Vision Institute uses the innovative NERVE FIBER ANALYZER (NFA) to perform a quick, thorough, noninvasive test for early signs of glaucoma. The NFA can detect nerve fiber loss and early onset glaucoma years before older testing methods don't settle for anything less than an NFA test to monitor the health of your eyes! The NFA test allows for early intervention treatment options, before glaucoma has compromised your vision.

Utilizing a unique combination of polarized light and scanning laser ophthalmoscopy, the NFA rapidly scans the retina and measures the thickness of the nerve fiber layer. The results reveal whether a patient is within/outside normal limits or borderline with respect to clinical indications for early glaucoma. This test does not require the patient's eyes to be dilated. There are no bright flashes of light, no pain or discomfort. It is recommended for patients with pre-existing early stage glaucoma, or any patient considered at risk for glaucoma. - back to top

Ocular Response Analyzer (ORA)

Eye pressure is a known risk factor for the development of glaucoma. Commonly used eye pressure measuring devices, such as the Goldmann tonometer, utilize a technique that involves touching the eye. The pressure required for the tip of the Goldmann tonometer to flatten the cornea is recorded. However, it is known that some patients with apparently normal pressures recorded with this device still go on to develop glaucoma; others with high pressure readings never develop it.

Pepose Vision Institute is one of the few centers in the U.S. chosen to evaluate the Ocular Response Analyzer (ORA), developed by Reichert Instruments, as a potentially more sensitive and accurate approach to measuring eye pressure. Not only does this Analyzer offer a potential breakthrough in detecting glaucoma in those patients with truly elevated eye pressure, but it can likewise save millions of dollars in pharmacy costs for patients that actually have normal eye pressure but have been measured improperly using current measurement techniques.

Errors in measuring ocular pressure have been found to be related to corneal thickness, and will therefore be affected by laser vision correction procedures that change a patient's corneal thickness. PVI is one of only a handful of eye centers in the country that has conducted clinical research related to this measurement issue. If you have had laser vision correction, or have naturally changing corneal thickness due to a chronic condition such as keratoconus, it is crucial that you select an eye care professional who is well-versed in differentiating between real increases in eye pressure and simple measurement error. Our cornea subspecialty-trained physicians have substantial experience in the diagnostics required to accurately measure true intraocular pressure for vision correction patients and others with corneal conditions, thereby enabling us to determine the optimal treatment to preserve and protect your vision. - back to top

PASCAL Dynamic Contour Tonometry

Pepose Vision Institute has conducted studies that show that eye pressure measurements with the PASCAL dynamic contour tonometer may be more accurate than the standard tonometer, which flattens and compresses the cornea. In addition, the Pascal instrument appears less sensitive to naturally occurring variations in corneal thickness and rigidity that can affect eye pressure measurement and choice of treatment regimen. - back to top

Frequency Doubling Visual Field Pachymetry

Assessing a patient's visual field is an important step in evaluating the progression of glaucoma. Pepose Vision Institute uses the sensitive frequency doubling visual field testing device for this purpose. This technology has been shown to be extremely sensitive in detecting early loss of side vision resulting from glaucoma. In addition to this greater sensitivity, the frequency doubling visual field testing device provides a more rapid assessment of visual fields than older devices, which were extremely tiring for the patient to complete. - back to top

Selective Laser Trabeculoplasty

For patients who are on many eye drops to control their glaucoma, or do not have an optimal response to the drops, a new "cold laser" in-office treatment (Selective Laser Trabeculoplasty) may be used to decrease the intraocular pressure in patients with chronic open angle glaucoma. Oftentimes, this procedure can eliminate the need for one or more of the eye drop medications. Pepose Vision Institute is one of the first eye practices in the bi-state area to offer FDA-approved SLT to its patients.

Traditional laser treatment for open angle glaucoma (OAG) applied an argon laser to burn tissue to create tiny, evenly spaced openings in the eye's trabecular meshwork to improve the draining of eye fluid. Unfortunately, the heat generated by this procedure often results in scarring around these openings, limiting its success and/or ability to retreat the eye in the future should the treatment need to be repeated.

The advanced, FDA-approved "cold laser" in an in-office procedure, referred to as Selective Laser Trabeculoplasty, does not treat glaucoma by burning tissue. Instead, SLT selectively treats only specific cells to stimulate increased fluid drainage. SLT produces equivalent drops in eye pressure as earlier laser methods, yet it results in less tissue damage, thereby avoiding adverse scarring effects. For this reason, SLT can be repeated throughout a patient's life when clinically indicated. Moreover, it is often found to be successful when traditional laser methods fail to appreciably reduce eye pressure. - back to top