I have glaucoma in both eyes (it is more severe in my left). Are researchers working on regenerating the cells that are damaged in glaucoma? [ 03/27/13 ]
Thanks for your question. Many researchers, including myself, are working on regenerating optic nerve cells. This area of research is very exciting and moving quickly. However, even once the optic nerve cells are regenerated, they have to link up with the correct cells in both the eye and the brain. The optic nerve cells transmit a great deal of visual information and replacing them will not be as simple as injecting the replacement optic nerve cells into the eye. I do not think it is an impossible task, but it is a long-term project.
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 78 years old and have been told that I have narrow-angle glaucoma that needs a laser iridotomy procedure. My eye pressure was always fine except for one time when I was receiving cortisone shots for a knee injury, and the pressure increased to 20/21. Since that episode, for the last three years, my pressure has remained at 11/12. I have read that I may have some serious problems if I undergo the laser procedure and this frightens me. There is a history of narrow-angle glaucoma resulting in blindness on my father's side of our family. Right now my vision is 20/20 with glasses and I don't want to ruin it. Can you tell me what the side effects are of this procedure and what the potential long-term effects will be on my vision? [ 03/27/13 ]
Thanks for your question. Yes, while it is true that laser iridotomy can have side effects, let me first start out by saying that overall it is a fairly low-risk procedure. As you know from reading medication labels, many side effects will be listed but it is hard to tell which ones are most common. I usually advise my patients about the following issues, although this is not an exhaustive list.
There can be an eye pressure spike after the procedure, but I usually treat this in the clinic and have my patients wait 30-60 minutes after the procedure so we can check for this. I also tell my patients that the eye is like a camera, with the pupil acting as the aperture. After the laser you will have an extra “aperture” so theoretically stray light can enter the eye and cause halos, double or blurred vision, and glare. I generally place these holes superiorly, as long as the eyelid completely covers the hole created in the iris. Others will place the iridotomy at the 3 or 9 o’clock positions. There is also the side effect of inflammation, which is why I ask my patients to use a short (one week) course of topical steroids (or non-steroidal anti-inflammatory eye drops if they are very sensitive to topical steroids). Of course, there are other side effects that you will come across if you read a great deal, but overall I would say that if you have narrow angles (and a family history of narrow-angle glaucoma resulting in blindness) the benefit would outweigh these risks.
Ultimately, it might be helpful for you to bring the information presented above to your eye doctor and have a thorough conversation with him/her about the laser iridotomy procedure, so that you can feel that all of your questions are adequately answered.
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.
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.
My father is 52 years old and has been suffering from glaucoma in his right eye for over three years. He has had four surgeries throughout this time without improvement. Now the vision in his left eye is getting worse with each day. What do you suggest that we do? [ 02/25/13 ]
Thank you for your question. Glaucoma is a very difficult condition to treat. I often tell my patients who come in with one eye having very severe glaucoma that we will do everything to treat that eye, but we must not neglect the other eye, which often shows earlier stages of the disease that can progress over time. I would first bring your concerns to your ophthalmologist, and make sure that your father is thoroughly examined to determine if there are other eye problems responsible for his vision loss. For example, are the visual problems related to a worsening cataract, which could be addressed by cataract surgery or new glasses? If it is indeed glaucoma, then it is likely that he will need more aggressive treatment than he is currently undergoing in order to halt the disease. You mention that he has had four surgeries without improvement. Unfortunately, glaucoma never “improves”; doctors can only stop its insidious progression. It may also be worth seeing a glaucoma specialist for a second opinion.
My mother-in-law has recently being diagnosed with glaucoma. The doctor said that she has only 5 percent vision, and that pressure (i.e., constipation or lack of sleep) can lead to blindness. The doctor said that there is nothing that can be done now. I appreciate your thoughts on this. [ 02/25/13 ]
Thank you for your question. Based on your question, it sounds like your mother-in-law’s glaucoma went undetected or was diagnosed very late. Unfortunately, glaucoma causes irreversible vision loss. However, despite the fact that she only has 5 percent vision, there are treatments to ensure that she does not lose the remaining 5 percent.
Is your mother-in-law taking eye drops? Has she had laser surgery to lower eye pressure? These two treatments should be considered first before surgery, which is also an option. You did not mention if the glaucoma is affecting both eyes equally, but every measure should be taken to ensure that her vision remains as strong as possible.