Is there a relationship between glaucoma and macular degeneration? I have glaucoma and now my ophthalmologist has spotted reduced pigmentation in the left retina and has scheduled me with the macular degeneration specialist. In case it matters, I was diagnosed with glaucoma when I was 19. I am now 56, have poor vision, rheumatoid arthritis, multiple sclerosis, and now possibly macular degeneration. Concerning the macular degeneration issue, I thought that smokers should not take beta-carotene supplements. Is that true? Thank you for your help. [ 02/25/13 ]
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.
I recently had an eye examination as a follow-up from a recent uveitis infection in my right eye. The specialist mentioned that I showed signs of developing glaucoma in my left eye, so I will have a follow-up appointment in six months. Vision and eye pressure readings were okay, but the optic nerve was presenting differently than the other eye. I would appreciate your input. [ 02/25/13 ]
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.
I am presently taking Cosopt and Xalatan. I was taking Alphagan-P, but had to stop due to an allergic reaction to it. My doctor has prescribed a pill for me to try, and I also am scheduled to have laser surgery on my right eye in December. My eyes pressure was 27 and 28 during a recent eye exam. [ 02/25/13 ]
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.
I am 81½ years young, have had 13 major surgeries, and had cataracts removed from both eyes in 2003. I wear glasses in bright lights or when I am outdoors. I am home bound and disabled; it is really bad most of the time, but I do read a lot. When I went to the eye doctor in October, the eye pressure in both eyes was 15. My ocular pressure has been below 18 all the time, but now it is 15. I have since quit eating everything with wheat in and lost weight, which I also think has helped me; I have less bloating and swelling. I am allergic to all sulfa drugs, dye, aspirin, and phen medications. Also, I have lost most of my intestines and stomach; have heart trouble, arthritis, and GERD. I can’t use drops without my eyes burning and getting blood red, but was curious if there is anything else I can use? [ 02/25/13 ]
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.
My wife had selective laser trabeculoplasty (SLT) for glaucoma in her left eye and was scheduled to visit the eye doctor one week later to have the procedure performed on the other eye. The doctor mistakenly performed the procedure on the left eye instead of the right and then proceeded to work on the correct eye. Do you think we will notice any problems with her left eye due to the double procedure? [ 02/25/13 ]
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.
My mother, who is 77 years old and lives in a rest home, has glaucoma but not Alzheimer disease. They have had an Alzheimer’s patch on her for an unknown period of time. What will this do to her and how will it impact the glaucoma? [ 02/25/13 ]
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.
My nine-year-old daughter had an eye exam yesterday. Other than her high eye pressure, she had above normal limits in her retinal nerve fiber layer exam in one eye and the results were borderline in another. The ophthalmologist suggested that she could have glaucoma, but could there be another reason? Should I be worried? [ 02/25/13 ]
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.
How long does a basic glaucoma test take to perform? [ 02/25/13 ]
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.