Ask an Expert about Glaucoma

Thank you for your question. Glaucoma and macular degeneration are not related in the sense that having glaucoma does not increase your risk of macular degeneration or vice versa. However, both are age-related diseases, although you were diagnosed with glaucoma at a young age. The good news is that some forms of macular degeneration, such as the dry form, may be very stable for many years and not cause problems, and eye doctors have newer treatments to treat the wet form should that occur.

The results of a large clinical trial did show that beta-carotene can increase the risk of lung cancer in current smokers, so smokers should avoid this supplement.

Thank you for your question. Based on your description, it sounds like your ophthalmologist thinks you may be a “glaucoma suspect,” based on the appearance of the optic nerve. There are characteristic features of the optic nerve that make one suspicious about glaucoma, and ophthalmologists have to weigh the evidence in suggestive but not definitive cases. For example, you will likely undergo formal visual field testing and optic nerve imaging. In addition to the information gathered from the tests, your doctor will consider whether you have other risk factors, such as family history, thin corneas, or topical steroid use. Follow-up visits with your ophthalmologist are important for your care, as the diagnosis of true glaucoma will be made over time.

Thanks for your question. I hope that the laser procedure is successful in lowering your eye pressure. I am surmising that the pill your doctor prescribed is either acetazolamide or methazolamide. I do have patients who have been able to tolerate the pill for lowering eye pressure, but usually as a temporizing measure until more definitive treatment can be performed, such as laser procedures or surgery. I also take care of a small minority of patients who absolutely do not want surgery and would rather try to take the pill long-term. However, there are side effects of these pills that can affect not only health but quality of life, so most of the time patients then proceed to more definitive treatment. Please visit the treatment section of this website for more information about medication, laser and surgical procedures for glaucoma.

Thank you for your question. You didn’t mention which eye drops you are using, but certainly some eye drops are more irritating than others, and each patient is unique. I would first consider whether there are medications that you haven’t tried yet that will be tolerable in terms of side effects. It is also possible that some of your side effects are due to the preservatives contained in eye drops, and now there are some newer, preservative-free formulations of eye drops and this is certainly worth asking your ophthalmologist about. Another option is to consider laser treatment for your glaucoma. It is not a “cure” and the eye pressure lowering effect does not last forever, but it could provide you with some relief if the laser is effective and you don’t need to use eye drops anymore.

Thanks for your question. I have not had experience with the situation you describe in terms of performing the procedure twice in the same eye so close together. It is possible with multiple laser treatments that there might be more inflammation after the second procedure. Generally I do not prescribe patients anti-inflammatory eye drops after the laser procedure, because I want the eye’s own healing process to take place. But perhaps your wife’s ophthalmologist elected to prescribe anti-inflammatories. One reassuring fact is that we do often re-treat the same eye after the effect of the laser wears off. So, it is possible that in the long-term there will not be any issue with having had the procedure performed twice. It is always an option for you to seek an opinion concerning your questions from another ophthalmologist who can examine your wife’s eye and review the medical records.

Thank you for your interesting question. I am assuming that the patch you are referring to is an anticholinesterase inhibitor. One of the medications that is less commonly used for glaucoma, pilocarpine, has a similar (although not the same) mechanism of action. Other medications that have a similar mechanism of action to the Alzheimer’s patch have been used to treat glaucoma in the past. So, if anything, I would surmise that this patch is not harming your mother’s glaucoma and could be potentially lowering her eye pressure. However, I would have a discussion with your mother’s physician about the purpose of the Alzheimer’s patch.

Thanks for your question. When we measure retinal nerve fiber layer thickness, the patient’s data is compared to a database of “normal” patients. For children, this does not yet exist. There is a recent publication from a group in Texas that examined “normal” children, so now we do have some guidance as to what is “normal” or “abnormal” in children, such as your daughter. In answering your question, it would be helpful to know her eye pressure and cornea thickness, any other risk factors such as family history or other ocular conditions, and the appearance of her optic nerve. Based on what you’ve written, I would recommend continued follow-up with your ophthalmologist. Often, the diagnosis of glaucoma is made over time, as doctors evaluate any progressive changes that may occur.

I am not sure what you are referring to in terms of a “basic glaucoma test,” but I would recommend that if you are at risk for glaucoma or want to be examined for it, that you have a comprehensive examination performed by a board certified eye doctor. You will have your history taken, and a complete examination including: vision, eye pressure, corneal thickness, drainage angle examination (gonioscopy), slit lamp examination, optic nerve examination, visual field testing, and optic nerve imaging, if needed. A full examination can take an hour or two to complete.