2027F Optic nerve head evaluation performed (EC)

Name of the Procedure:

Optic Nerve Head Evaluation (EC)
Common name(s): Eye check for glaucoma, Papilledema evaluation

Summary

An optic nerve head evaluation is a diagnostic eye exam to assess the health of the optic nerve, which is crucial for vision. This procedure checks for signs of damage or diseases affecting the optic nerve, such as glaucoma or swelling due to increased intracranial pressure.

Purpose

The medical condition or problem it addresses:

• Glaucoma
• Papilledema
• Optic neuritis
• Optic neuropathy
  The goals or expected outcomes of the procedure:
• Detect early signs of optic nerve damage
• Determine the extent of existing damage
• Monitor progress of known optic nerve-related conditions

Indications

Specific symptoms or conditions that warrant the procedure:

• Sudden vision loss
• Persistent headaches
• Eye pain or discomfort
• Changes in peripheral vision
  Patient criteria or factors that make the procedure appropriate:
• History of glaucoma
• Suspected increased intracranial pressure
• Family history of optic nerve diseases

Preparation

• No specific fasting or dietary restrictions.
• Ensure patient has removed contact lenses if applicable.
• Inform the patient about the use of dilating eye drops if required.
• Possible preliminary vision tests (e.g., visual acuity, perimetry)

Procedure Description

• Patient is seated comfortably with head stabilized.
• Use of a slit-lamp biomicroscope to visualize the optic nerve head.
• Application of dilating eye drops may be necessary for better visualization.
• Direct and/or indirect ophthalmoscopy is performed.
• Digital imaging or Optical Coherence Tomography (OCT) might be used for detailed analysis.
• If necessary, intraocular pressure (IOP) measurement using tonometry.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Performed in an ophthalmologist's office or specialized eye clinic.

Personnel

• Ophthalmologist or optometrist
• Trained ophthalmic technician (for imaging or support)

Risks and Complications

Common and rare risks:

• Temporary blurred vision due to dilating drops
• Light sensitivity
• Rare allergic reactions to drops
  Possible complications and their management:
• Allergic reaction: Administer antihistamine drops
• Temporary discomfort: Provide patient with dark glasses and rest

Benefits

• Early detection of optic nerve damage
• Prevention of severe vision loss through timely intervention
• Accurate monitoring of known conditions to inform treatment adjustments

Recovery

• Patient may experience temporary blurriness and light sensitivity; usually resolve within a few hours.
• Avoid driving immediately after the procedure if dilating drops were used.
• Follow-up appointments as necessary for monitoring and treatment.

Alternatives

• Visual field testing: Assesses peripheral vision loss.
• Electroretinography (ERG): Measures electrical responses of the retina.
• MRI or CT scan for detailed optic nerve imaging.

Pros and cons of alternatives compared to the described procedure:

• Visual field testing is non-invasive but may not provide detailed optic nerve information.
• ERG offers retinal function insights but is more complex and less specific for optic nerve assessment.
• MRI/CT provides comprehensive imaging but is more expensive and less readily accessible.

Patient Experience

• The patient might feel slight discomfort from bright lights or when eye drops are applied.
• Mild discomfort due to eyelid stabilization.
• Light sensitivity and blurred vision post-dilation are common but temporary.
• Pain management typically not necessary beyond mild discomfort alleviation.