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Ask an Expert about Glaucoma

Latest Questions and Answers
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!

I was diagnosed with open-angle glaucoma when I was 17 and apparently I have had glaucoma for two years. Now, I am a 19 years old and I have been on Travatan Z for the past two years. My doctor does not really tell me much about glaucoma, so I would appreciate your help. How can I have a more meaningful life with glaucoma? What can I do to prepare myself for the future? How soon might I go blind? Please help me; I would be so grateful. [ 06/04/13 ]

Thank you for your question. I understand why this must be frightening because you are so young. The good news is that glaucoma, if well-controlled, is a slowly developing disease. Glaucoma is a disease of the optic nerve, and the reason it is a challenging disease is that most patients do not know they have glaucoma as there are no symptoms until late in the disease. As the cells of the optic nerve die, first the peripheral vision is affected, and then slowly this can worsen until late in the disease when central vision is affected. Our goal as ophthalmologists is to slow the disease down so that patients do not experience these visual symptoms. There are plenty of people with glaucoma who live very meaningful lives. The important thing is to find a doctor you trust and always make sure you continue to follow-up with your appointments. I cannot answer your question about blindness as I do not know how severe your glaucoma is and what your rate of disease progression is. This is something that your ophthalmologist should have a sense of as he/she takes care of you and your eyes. I hope this helps, and good luck!

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!

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!

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!

Why would one have to have their eye removed due to glaucoma? [ 06/04/13 ]

Thanks for your question. If the eye is completely blind from glaucoma, and painful, then it would be reasonable to consider removing the eye. However, even for blind and painful eyes, doctors can offer an injection of an agent that can reduce or eliminate the pain. This is preferable as it allows the patient to maintain the eye, even though it is blind. I would discuss this option with your ophthalmologist if this is an issue you are facing.

I am 77 years old and have suffered from open-angle glaucoma for 27 years. Both eyes had been treated with Betagan, which caused bronchial spasm; Alphagan, which caused orthostatic hypotension; and Azopt, which caused skin eruption. My left eye is worse; it had a trabeculectomy 12 years ago, and the procedure led to the loss of central vision. Now I am only using Travatan Z in my right eye. My new eye doctor said that I need a trabeculectomy performed on my right eye now. Due to central vision loss in my left eye after previous surgery, I am very nervous about getting this surgery done on my right eye, in which I have 20/30 vision. What are the odds that I will lose the central vision in my right eye after surgery this time? I also would like to know what the chances are that I will go blind in five years. Thank you. [ 06/04/13 ]

Thanks for your question. Unfortunately, the phenomenon that you describe, in which one can lose central vision after a successful trabeculectomy, is a very rare occurrence but does happen. I can certainly understand why you are nervous about having trabeculectomy performed on your right eye. It is difficult without examining your eyes to know what the risk of losing central vision in your right eye is, as some of it depends on how advanced the glaucoma and visual field loss is. Furthermore, it is hard for me to assess your risk of blindness without knowing your rate of visual field loss over the last 27 years. What we do know is that if you don’t have any interventions and your glaucoma is not well-controlled, you will eventually lose more visual field, but it is important to assess over what time period. These are questions you should certainly ask your ophthalmologist. If you don’t feel comfortable asking him or her, perhaps seeking a second opinion and asking these very questions will help you in your decision. 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!

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Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

Last Review: 04/28/13

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