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What Is Pachymetry in Optometry?
A pachymetry is a way for optometry professionals to measure the thickness of the cornea. This test is performed for a variety of reasons, such as to determine if the patient is a good candidate for surgery or to look for indicators of glaucoma (more on this below). This review discusses pachymetry in optometry in greater detail.
Pachymetry in optometry explained
The field of optometry is devoted to the study and identification of abnormalities and defects in the eye. It is particularly concerned with detecting and correcting refractive errors that cause vision problems. In the past, this was accomplished almost exclusively with corrective lenses such as glasses or contacts. However, it is now increasingly common for eye doctors to correct refractive errors permanently through surgical means.
Refractive errors are often due to structures located in the front of the eye having difficulties properly focusing light onto the back of the eye. The cornea has a lot to do with the eyes' ability to focus light. It is a dome-shaped structure that covers the iris and pupil and is responsible for two-thirds of the eye's refractive power.
The purpose of pachymetry is to measure the thickness of the cornea. This is important when planning a surgical procedure to correct a refractive error. It can determine whether the patient is a candidate for optometry surgery and tells the doctor how much of the cornea to remove.
Methods of pachymetry
There are two methods of measuring the thickness of the cornea through pachymetry. Optical pachymetry is the newer type. It allows the optometrist to measure the cornea microscopically to determine the thickness. It does not require the instrument to come in contact with the cornea itself. However, the downside of optical pachymetry is that insurance companies may not pay for it.
Ultrasound pachymetry is the more traditional method. It involves the use of a sensor that comes in direct contact with the cornea. However, this does not cause any pain. The assessment involves sending ultrasonic waves into the eye and measuring when and how they reflect back. These measurements indicate the thickness of the cornea.
An ultrasound pachymetry device is portable and cost-effective. However, the measurements are only usable if the device is positioned perfectly on the eye.
Reasons for pachymetry
Refractive surgical procedures, such as LASIK, require an eye doctor to remove a portion of the cornea to change the way it focuses light on the retina in the back of the eye. It is important to determine the cornea's thickness beforehand. If it is too thin at baseline, removing a portion may result in permanent vision damage; therefore, the patient would not be a candidate for surgery. Pachymetry is also a necessary part of the surgical planning process for patients who are candidates. However, there are other reasons why pachymetry is performed.
Glaucoma is a disease that causes increased pressure in the eye. Corneal thickness is an independent indicator of glaucoma risk, and the thickness of the cornea may affect readings of intraocular pressure. Therefore, it is increasingly common for glaucoma testing to include pachymetry.
The cornea can swell due to excess fluid. This occurs for a number of reasons. Some people experience swollen corneas due to wearing contact lenses. There are also diseases that can cause corneal swelling, including Fuchs' dystrophy. Pachymetry can show an increase in thickness even when examination with a microscope cannot.
What to expect during a pachymetry procedure
Before the test begins, the eye doctor provides the patient with numbing drops to ensure they experience as little discomfort as possible. In fact, many patients report no discomfort at all during the procedure. As mentioned, a small probe of the pachymeter is used to touch the cornea of the eye, and ultrasound waves are used to measure the thickness of the cornea.
In total, the test only takes approximately a minute for each eye. The results are then studied by the eye doctor and their staff. As discussed, there are several reasons why the test is performed, and the eye doctor can provide a treatment recommendation based on their findings.
How to prepare for your pachymetry procedure
Since a pachymetry procedure is minimally invasive, there are not usually any special instructions that must be followed. Simply show up at your scheduled time. It may help to arrange for a ride home in case of eye discomfort after the visit.
Measuring the thickness of the cornea during an optometry exam is important for several reasons. Pachymetry offers multiple options by which to accomplish this goal.
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