I am 63 years old and my eyes have become a lot worse during the last three years. My eye doctor thinks it may be due to diabetes or my thyroid, because my vision has changed five times in my right eye and four times in my left eye. Are these changes normal? [ 06/04/13 ]
Thanks for your question. Without examining your eyes, it’s difficult to know for sure, but it is possible that you could have fluctuating vision as you described, especially if your diabetes is not well-controlled. You did not mention whether the decrease is mostly for distance or near vision, and certainly as we get older our near vision can become more and more blurry. I would recommend that you have a comprehensive examination that includes dilation to rule out any other problems. However, it is possible that you will need your glasses updated yearly. Good luck!
I am 86 years old and I would like to know what caused the glaucoma and cataracts in both eyes. Are they inherited? Does eye strain cause these disorders? Can the use of dark glasses when outdoors prevent glaucoma and cataracts? What is done to remove glaucoma? Isn’t there an operation or laser treatment to correct this condition? [ 06/04/13 ]
Thank you for your question. Some forms of cataract and glaucoma are inherited, but most cases are age-related, although there are certainly genetic risk factors. Eye strain does not cause cataract or glaucoma. Wearing dark glasses will not prevent glaucoma, but it does help delay cataract formation. Certainly, sunglasses are a good idea for general eye health. While we do have cataract surgery to correct the condition of cataracts, there is no treatment that corrects glaucoma. What we do have are medications, lasers, and surgeries to lower eye pressure, which slows the progression of glaucoma. The goal of glaucoma treatment is to offer patients a well-tolerated treatment that prevents vision loss. Good luck!
I have been diagnosed with glaucoma. My ocular pressure, before starting treatment, was generally 18 in right eye and 19 in left eye. My doctor said I had thin corneas (I had Lasik two years ago), which means my eye pressure readings are artificially low. After taking eye drops (Lumigan first and then Zioptan) my most recent pressure was 16 in the right eye and 13 in left eye. The visual field test showed progression of peripheral vision loss in left eye, however. My doctor wants to perform a selective laser trabeculoplasty in left eye (SLT). I want to be sure that there is no other problem that is contributing to the vision loss. Should the doctor suspect other causes of vision loss, such as those caused by cardiac or pulmonary issues? Should I have other tests done to see if there is poor circulation to optic nerve? [ 06/04/13 ]
Thanks for your question. Your story sounds most consistent with glaucoma progression. However, one approach you could consider is to repeat the visual field and ensure that there truly is progression. Perhaps this has already been done? I like to repeat the test to document whether there has truly been progression. Another option is to consider additional medications before SLT. But your real question is whether there are other cardiac or pulmonary issues that could be at play. One risk factor that has become more accepted is blood pressure, especially diastolic blood pressure. Your blood pressure is related to your ocular perfusion pressure, which could be a risk factor for glaucoma progression. You did not mention whether you have blood pressure issues, but if you are on medications for this condition, it may be worth ensuring that your blood pressure is not too low as this can result in decreased blood flow to the optic nerve. I hope this helps, and good luck!
Why do cataracts lenses cause “wandering” or double vision in the implanted eye? What remedies and treatments are available to help improve vision lost as a result of laser surgery performed supposedly to reduce eye pressure? [ 06/04/13 ]
Thanks for your questions. As to your first question, I am not sure what you mean by “wandering” vision in an eye that has had cataract surgery. In terms of double vision, it is important to distinguish double vision just with one eye open, or both eyes open. The implanted lens is placed in a “bag” and sometimes the bag has wrinkles or a film that grows on it, which can be resolved by performing a laser procedure in the clinic. I am not sure based on your question whether it would help your symptom, but it is certainly worth asking your ophthalmologist. Typically, laser procedures performed to reduce eye pressure should not cause one to lose vision. Without knowing any additional information, this question is hard to answer. Is it possible that you had inflammation in reaction to the laser, and this caused some decreased vision? In this case doctors could treat the inflammation and that could help with your vision. If you could provide more details about your clinical history I may be able to help you more. Good luck!
I was misdiagnosed for glaucoma, despite frequent visits. I have since been using several eye drops and had surgeries performed on both eyes. The vision in my left eye is now completely gone and I can no longer enjoy even my peripheral vision, which disappeared one week ago. What should I expect to happen to my vision next? Can I benefit from stem cell therapy? What are the available resources and contacts? I am desperate to have some vision to perform my duties as a pharmacist. Thank you. [ 06/04/13 ]
Thanks for your question. I am so sorry to hear about your vision loss. Unfortunately despite optimizing eye pressure, some patients still suffer from worsening glaucoma, which sounds like is the case for you. It would be worth discussing with your ophthalmologist and primary care doctor about other risk factors for worsening glaucoma, such as low blood pressure, and optimizing these risk factors, if present. In terms of stem cells, currently there is ongoing research in this area, but no product or stem cell transplantation available. However, there are clinical trials for glaucoma treatments that protect the optic nerve.
You could check clinicaltrials.gov to see if there are any trials enrolling glaucoma patients for neuroprotective treatments. I hope this helps, and good luck!
My optometrist diagnosed me with glaucoma. My eyes are very healthy and I was not given any particular treatment other than a prescription for glasses. Is there a way to look at the prescription and determine the eye pressure? Is it normal not to be on some sort of treatment if a person is diagnosed with glaucoma? [ 06/04/13 ]
Thanks for your question. No, the eyeglass prescription does not give any information about eye pressure. I suspect that if you have not been started on any treatment then your optometrist is suspicious that you have glaucoma, or considers your risk of developing glaucoma very low, and has therefore not recommended treatment. It is also possible that your optometrist wishes to follow you as a glaucoma suspect, obtain tests including an optic nerve imaging test, and then determine if you should be on treatment. Do you have follow-up scheduled? Have you had an optic nerve imaging test and a visual field? These are typical steps an optometrist or ophthalmologist will take when performing a glaucoma evaluation. Good luck!
Will the large amount of fluid required for a colonoscopy preparation cause my eye pressure to increase? Is there anything I need to talk with the gastroenterologist about concerning my glaucoma? The pressure in one eye has caused some visual field damage and I have had surgery in the other eye due to a massive amount of damage. [ 06/04/13 ]
Thanks for your question. I would definitely discuss this question with your gastroenterologist. Certainly we do know that a large amount of fluid ingested in a short amount of time can increase eye pressure, especially in patients with glaucoma. Polyethylene glycol solutions that are commonly used for bowel preps are not supposed to cause large fluid shifts or electrolyte imbalances. I recommend discussing with your gastroenterologist whether you can take a low-volume prep and divide it over several doses and/or longer time period. This should help in terms of decreasing any risk of an acute eye pressure increase. Good luck!
In 2008, there was a study by Dr. Parisi that spoke of the very positive effects of citicoline in treating glaucoma. I recently saw that a patent for topical citicoline was just approved. How safe is it to take citicoline as a capsule supplement, in addition to Travatan Z to help treat glaucoma? If it is safe, what would be the recommended dosage? Thank you. [ 06/04/13 ]
Thanks for your question. I recently heard Dr. Parisi discuss the results of oral citicoline treatment of patients in Italy. I personally have no experience with citicoline use, as it is not FDA approved for glaucoma treatment in the U.S. It has been used for stroke and Alzheimer’s in Europe and Asia, but in the U.S. it is a dietary supplement. It is important to note that they observed regression of improvements in visual function when the drug was discontinued. This is important because we do not know the long-term effects of continued citicoline usage. Furthermore, there are side effects including blood pressure instability, chest pain, and headache. At this point, I would recommend that you speak about this with your ophthalmologist and primary care doctor in terms of the safety of taking this supplement in your particular situation. Good luck!