My question pertains to glaucoma that is associated with nail-patella syndrome. My father and I both have glaucoma, and my daughter, who will be 3 in March, already has optic nerve cupping. Has any research been done recently on this disorder? When I was diagnosed four years ago, the pressure in my left eye was 33 and was 46 in the right eye. Eye drops and surgery were unsuccessful. I am 33 years old and despite medications my left eye seems to be getting rapidly worse. Any input would be appreciated. [ 03/27/13 ]
Thank you for your question. I am sorry to hear about the progression of your glaucoma. If your current medications and prior surgery seem to be failing, I would recommend asking your ophthalmologist what else can be done medically or surgically, or perhaps even obtain a second opinion. In terms of research for nail-patella syndrome, there has been a genetic mutation in a gene called Lmx1b that has been linked to some patients with nail-patella syndrome and glaucoma. You could talk with your eye doctor about genetic testing, but any genetic testing has ramifications that need to be carefully considered. I would also seek to ensure that your daughter is followed by a pediatric glaucoma specialist, if she is not already being seen by one.
Are there certain vitamins or supplements that I can take to improve optic nerve health and overall eye health? I have read about a special supplement formula from a brochure in my eye care practitioner’s office, and I was considering trying it. However, I have found no reviews on this product so I am a little wary. Also, I was told that I am suffering from retinal/ocular/ophthalmic migraines and I also have “visual snow,” which is referred to as “persistent migraine aura.” Since these conditions are neurological, can they be causing my increased eye pressure? I'm still very young so I need to preserve my vision as long as I can. [ 03/27/13 ]
Thanks for your questions. To answer your second question, it is unlikely that your ophthalmic migraines are affecting your eye pressure. However, in some patients with glaucoma who have “normal” eye pressure, it is thought that migraine can be a risk factor. In terms of vitamins or supplements, I would recommend a healthy diet with plenty of green leafy vegetables and healthy fats from cold water fish rich in omega-3s, for example. If you are concerned about your dietary health, you can always take a multivitamin. There is no scientific evidence at this juncture demonstrating that special supplement formulations to be of benefit for those with glaucoma.
I have been diagnosed with glaucoma and I am only 19 years old. I am currently taking eye drops to reduce the eye pressure. How much progress is being made in regenerating optic nerve cells to restore the lost vision? How many years do you think it will take before that cure has been discovered and can be used to treat patients? I am personally very worried, since I am very young and want to keep my vision for the rest of my life. [ 03/27/13 ]
Thanks for your question. Many researchers, including myself, are working on regenerating optic nerve cells. It is a daunting challenge because the optic nerve cells reside in the retina of the eye, and travel a great distance to the appropriate targets in the brain. The optic nerve cells would have to link up with the correct cells in both the eye and the brain. I do not think it is an impossible task, but it is a long-term project. I do think that there are other promising approaches to treating glaucoma that will be more achievable in the short-term. For example, all of the medications, laser, and surgery we have to offer patients are aimed at lowering eye pressure; however, we know that for some patients that is not enough. I believe that in the next 10 years we should have other “neuroprotective” treatments that protect the optic nerve cells from dying in glaucoma and this will be of great help to many patients.
My six-year-old son has glaucoma and he is put under anesthesia twice each year for his eye pressure checks. Is it necessary to be sedated for something this minor? I have read that there will be an at-home pressure test pen. Is this true, and would it be a good option for us? [ 03/27/13 ]
Thanks for your question. Given that your son is six years old, he may be at the age at which soon he will be able to hold still and tolerate an eye pressure measurement in the clinic. But each child is different, so if he is not yet able to tolerate this in the clinic, then yes, he would need to have anesthesia for the pressure check. A frightened child who is squeezing his eyelids shut will not yield an accurate measurement and will render it meaningless. Many pediatric glaucoma specialists do have experience in measuring eye pressure in young children and are able to put them at ease. There are home tonometry units available now; however, given that your son is nearing an age for which in-office measurements should be possible, I would discuss this option with your ophthalmologist.
I am 17 years old and I have a severe pain in my right eye. The eye is really watery, I see zigzag lines, a gray blind spot, and sometimes the visual field appears has a greenish hue. What could be the cause of these symptoms? Could it be glaucoma? I know I have migraine but why is my eye hurting? Please help me; I don’t know what to do. [ 03/27/13 ]
Thanks for your question. The easiest way to answer the question about whether this could be glaucoma is to have an ophthalmologist perform a thorough eye examination. Without this examination, I can only speculate. Some of your symptoms, such as zigzag lines, sound consistent with ophthalmic migraine. However, other symptoms, such as eye pain, are harder to diagnose. Certainly, I would recommend that you have a comprehensive eye exam to answer your questions.
I am 44 years old, and had glaucoma-related surgery about eight years ago. My eye pressure is good; however, the vision in my left eye is almost non-existent. Is there any chance that I can get better vision? Is there a transplant that can improve my vision? [ 11/05/12 ]
I am so sorry to hear about your vision loss. As a glaucoma doctor, I wish I could offer my patients better vision. Instead, I explain that our goal is to preserve what vision remains. There is active ongoing research around the world exploring how stem cell transplantation might be able to help glaucoma patients. However, glaucoma is a more challenging disease to treat in this way than other diseases (such as patients who have lost vision due to retina diseases). This is partly because glaucoma affects the cells of the optic nerve, and the optic nerve cells stretch all the way from the retina to the brain, a very long distance. So not only would scientists have to be able to replace the cells of the optic nerve, but also coax them to wire long distances to the right location. It is a big challenge, but I hope that in your lifetime we will be able to offer you tools to help improve your vision. You may want to explore having a low vision evaluation, if you have not done so already, where doctors can help provide tools that will help maximize the vision you have.
2. Two years ago, at age 59, I became a glaucoma suspect because my cup to disc ratio was .5 in both eyes. My eye pressures consistently are 11 and 12, corneal thickness is 547 and 538, I have a normal visual field testing, and HRT is stable. Assuming everything remains stable, would I be considered a glaucoma suspect for the rest of my life due to my cup to disc ratio, or at some point would my ratio be considered normal for me? [ 11/05/12 ]
This is a very good question and one that ophthalmologists struggle with—that is, how to identify those glaucoma suspects that really will develop glaucoma. A cup to disc ratio alone of 0.5 in both eyes could certainly be normal for you. When ophthalmologists evaluate you for glaucoma, they take into consideration risk factors in addition to what they find during an examination. For example, age is a major risk factor for glaucoma, so as you get older, you may convert from a glaucoma suspect to having glaucoma. Family history is also a risk factor, which I am assuming you do not have because you did not mention it. Other factors include high eye pressure and corneal thickness, which are normal for you. However, a cup to disc ratio of 0.5 does not give the complete story. For example, there are certain features of an optic nerve that may be very suspicious for glaucoma, and the cup to disc ratio does not capture this. Overall, given your normal visual field and optic nerve imaging test (HRT), you may very well never develop glaucoma; however, it is still important to have a yearly exam to ensure that there is no progression or change.
My mother, who is 71 years old, had a retinal detachment, and also has a diagnosis of glaucoma. The retina was reattached, but now she has developed cataracts and can see very little out of her left eye. If she were to get a corneal transplant, will it restore her eyesight? She was also told that she had optic nerve damage. Thank you for your time. [ 10/25/12 ]
I am sorry to hear about your mother's vision problems. It is not clear from your question whether she has scarring or damage to the cornea that requires a cornea transplant. When ophthalmologists make decisions about surgery, they try to gather as much data to understand what the visual potential is, because all surgery entails risk, and it sounds like your mother might need both cataract surgery and possibly corneal transplant surgery. While cataract and damaged corneas can be replaced and essentially made clear again simply by replacing the lens or cornea, damage to the retina is sometimes not reversible and damage to the optic nerve from glaucoma is generally irreversible. This is because the retina and optic nerve are composed of neurons, which are cells that transmit electrical information. So, I would seek the opinion of a retina and glaucoma specialist to see if they deem the potential vision good enough to recommend surgery.