The role of the Pentacam HR device in diagnosing and monitoring patients with glaucoma

The disease glaucoma or green cataract, as it is popularly known, primarily refers to damage to the optic nerve. The Optic nerve is a structure located on the back segment of the eye, i.e. on the fundus (picture 1).

However, the mechanism of glaucoma itself is most often associated with structures located in the front third of the eyeball and are part of the anterior and posterior chambers of the eye.  Analysis of the structures that make up the anterior chamber of the eye is of great importance in diagnosing patients with glaucoma, as well as in deciding on the type of therapy to be applied.

Pentacam HR, which our clinic owns, represents the third generation of Pentacam devices and is the newest type of device of its kind in the world (Figure 2). This device enables fast, painless, non-contact recording of the morphological features of the anterior chamber.  Recording with this device takes only two seconds, which results in at least 50 photos (picture 3), which are automatically reconstructed into a 3d photo (picture 4), which gives us an insight into the following important data:

• Central thickness of the cornea: it has been proven that people with thinner corneas have a greater tendency to glaucoma, also the thickness of the cornea gives us an insight into the correction factors for more accurate measurement of intraocular pressure
• The size of the chamber angle: people with a narrower chamber angle have a predisposition to suffer from closed-angle glaucoma
• The volume of the aqueous humor in the anterior chamber: this parameter gives us an insight into the size of the chamber, as well as the assessment of the functionality of the basal iridotomy, a laser procedure performed on patients with closed-angle glaucoma
• The depth of the anterior chamber eye chamber: the anterior chamber due to high farsightedness or due to the pressure of the eye lens in advanced cataract gives us an insight into the mechanism of increased eye pressure and the approach to treatment
• Morphology of the iris: the position of the base of the iris towards the corner of the chamber is evaluated with dilated pupils, i.e. glaucoma as a tendency to close the angle in closed-angle glaucoma, as well as the morphological patency of the iridotomy and the relationship of the pupillary edge of the iris to the anterior capsule lenses.

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