My husband needs a new optic nerve because it is so damaged. Is this possible? [ 08/30/13 ]
Thank you for your question. This is actually something that I am asked quite frequently by my patients and their families. Unfortunately, even though we have made tremendous advances in research and the treatment of glaucoma, eye transplants or optic nerve transplants are not possible at this time. The most promising research in this area is stem cell research. There are several people exploring stem cell research to determine whether the stem cells can be used to help fix the optic nerve, but these studies are in their earliest stages. The use of stem cells to treat a damaged optic nerve is likely decades away. For now, our only treatment for glaucoma is to lower eye pressure by using drops, laser, and surgical methods.
I was diagnosed with glaucoma about five years ago, and I also have dry macular degeneration. Since I started taking drops, the nerves around my eyes have become more active and agitated. My eyes do not experience this agitation when I get up at night or in the morning for the first hour; however, as the day progresses, the intensity varies depending on different activities and the environment. Bright light definitely makes it much worse. It is hard to concentrate on reading, driving, and looking at a bright computer screen. Physical activity, such as bending over and walking also seems to make a difference. I wear sunglasses as much as I can, both inside and outside, but it does not completely control the symptoms. During the last six months the symptoms have been getting more intense. I have been using Cosopt and Brimonidine twice a day and Lumigan at night, in both eyes. I've had laser treatments twice in both eyes as well. Do you have any thoughts about my symptoms? [ 06/05/13 ]
Thanks for your question. I wonder if it’s possible that these glaucoma drops are irritating your eyes to the point that you experience these symptoms. Certainly we know that some patients have quite severe ocular surface disease after long-term usage of these eye drops. Your symptoms might be minimized during nighttime or early morning because your lids have been closed and the ocular surface is at its least irritated state. Bright light can certainly exacerbate symptoms of ocular surface irritation. It sounds like you’ve exhausted all medications and laser treatments, and the next step to reduce medication burden and better control your glaucoma would be surgery. Without knowing the stage of your glaucoma, I can tell you that there are now more and more options for glaucoma surgery. Please have a discussion with your ophthalmologist about whether it is time to start considering glaucoma surgical options. Good luck!
I am an 83-year-old female with glaucoma and I have developed cataracts. My doctor has been treating me for the past seven years and recommends their removal. He suggests Tecnis Multifocal intraocular lenses. He says I may see well enough to drive at night. My objectives are not to wear glasses but to see more clearly. So far, my personal research does not seem to encourage this lens for diseased eyes. I do appreciate your advice. [ 06/04/13 ]
Thanks for your question. As a glaucoma specialist, I do not recommend multifocal intraocular lenses for my glaucoma patients. This is because glaucoma patients already may have some difficulty with contrast sensitivity, and these lenses may exacerbate this. I would recommend that you have cataract surgery with a standard intraocular lens, which the vast majority of patients receive and subsequently see very well. However, the standard intraocular lens will only be able to give you good distance vision; you will still need to wear glasses for reading. Furthermore, if you do have astigmatism, these standard lenses do not correct that so you may still need to wear glasses for optimum clear distance vision. If you have astigmatism and want to have the astigmatism corrected (instead of wearing glasses), there are surgical maneuvers that can be done to improve this at the time of cataract surgery, or you can have a special toric lens implanted. 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 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!
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!
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.