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When Janine Twitchell visited FocalPoint at Crosstown Concourse for a routine, comprehensive eye exam, she never expected to be diagnosed with an Acute Narrow Angle, considering the fact she has never had any previous ocular problems. An Acute Narrow Angle puts a person at risk for Acute Closure Glaucoma, which could lead to vision loss.
“I struggled to understand what it was. I was in total disbelief,” said Twitchell.
“Incidental findings like narrow angle glaucoma are not uncommon. Many eye diseases and condition may not have symptoms that drive a patient to have an exam,” said Optometric Physician Whitney Hauser, OD, ’01. “This is one of the reasons annual eye exams should be a part of people’s wellness routine like visiting the dentist.”
Kelsey Newcome, ’19, who performed Twitchell’s eye exam, performed a skill known as gonioscopy to look more closely at her angle. It was clear that they were very narrow, and this could put her at risk for angle closure glaucoma.
“What’s interesting is that you will not have symptoms if you have a narrow angle which shows how important it is to have an annual eye exam even if you don’t have any symptoms,” said Newcome.
Despite being surprised with her diagnosis, Twitchell thoroughly enjoyed her experience at FocalPoint and was extremely happy that they saw first signs of her condition. “The service was wonderful, and the student was super thorough,” said Twitchell. “I want to give credit for being so thorough and quick to finding the problem.”
After Twitchell’s eye exam, Dr. Hauser and Newcome referred her for a laser peripheral iridotomy at University of Tennessee Health Sciences Center’s Hamilton High Center. The procedure was performed by her colleague Dr. Brian Jerkins.
“Narrow angle patients always concern me, because in many cases you can prevent glaucoma or significantly lessen the severity they may develop without appropriate diagnosis and treatment,” said Dr. Jerkins. Many of these patients have subtle signs or symptoms that can be picked up on routine exams that can detect those with narrow angles.
The iridotomy procedure is performed under topical anesthesia in an office procedure room setting. A contact lens is placed on the cornea with magnification to visualize the peripheral iris. A small full thickness hole or iridotomy is then made with the use of a YAG or Argon laser. This allows aqueous fluid to flow from behind the iris to the anterior chamber of the eye. This allows pressure to equalize on both sides of the iris or pupil causing the angle in many cases to open and the anterior chamber deepen. Once this is visualized, the contact lens is removed, and the procedure is completed.
“Once it was confirmed after exam that she did have narrow angles and she was in need of treatment a laser peripheral iridotomy was recommended in her case,” said Dr. Jerkins. “It was a delight to have a nice patient like Janine who is concerned about her health and seeks out care.”
Once the procedure was complete, Twitchell returned to FocalPoint for the remainder of her care.
“FocalPoint made me more aware of my eye health and the importance of early detection,” said Twitchell. "I’m so happy to have visited FocalPoint."