Science & Research

Thank you for your question. Your question is a difficult one to answer without more information about your optic nerve status and field of vision. But I do understand your question in the context of glaucoma as a slowly progressive disease. If you have seen an ophthalmologist you trust and he/she feels that you have glaucoma that would benefit from eye pressure lowering, it is certainly reasonable to take timolol maleate and latanoprost. You certainly can have a discussion with your eye doctor concerning how the quality of your life will be impacted by the glaucoma for the rest of your expected lifespan, and if there are treatments available that do not interfere with the quality of your life.

Thank you for your question. I am sorry to hear about your eye problems. I am not sure exactly what you are referring to by +1, but if I had to guess, this may be related to your refractive error, or the power of the lens that you need in order for optimum vision. It may also be the power of the lens in order to read, as +1 implies a far-sighted correction (far-sighted means that you can see far without a problem, but have difficulty with near vision). As we get older, we all develop presbyopia, and may require reading glasses, and +1 is a common correction.

In terms of glaucoma, if you had a comprehensive eye exam your doctor would have been able to assess your glaucoma status. Certainly you have a risk factor because of the family history of the disease, but that does not mean you necessarily have glaucoma. I would advise you to speak with your doctor about your concerns.

Thank you for your question. It would help to know what type of glaucoma surgery you had. I can tell you that your tearing, swelling, and feeling of something being in your eye are certainly consistent with glaucoma surgery (unfortunately), and are not necessarily related to diabetic retina. Most glaucoma surgeries require the use of dissolvable sutures, which can cause irritation, tearing, swelling, and the feeling of something being in your eye. On the other hand, these symptoms should have been improving over the four weeks since surgery; they should not be worsening. Sometimes my patients have more comfort with the use of ophthalmic ointments, which your surgeon can prescribe. The blurriness that you are experiencing may be related to your diabetic retina, especially if your surgery has caused more swelling in your retina. That being said, there are a multitude of reasons why your vision may be blurry, and it would be best to have these concerns addressed by your surgeon.

Thank you for your question. This is a difficult question to answer since there are many possible causes for your symptoms. Certainly, if you are older, cataracts could be causing your symptoms, especially the glare or the eye pain you experience during daylight. Cataracts also cause objects to be blurry and out of focus. However, in addition to cataracts, there are other possibilities for your constellation of symptoms. I described the symptoms of cataract because they are the most common cause of your symptoms in older individuals, but I recommend a comprehensive exam with an ophthalmologist in order to fully assess your condition.

Thank you for your question. It is a difficult one, but one that keeps me and many others motivated to discover ways in which we can repair the optic nerve. Unfortunately, the neural connections that needed to develop good vision during your childhood were interrupted by glaucoma. Based on your question, it sounds like the optic nerve was severely damaged by glaucoma when you were an infant. Once the cells of the optic nerve have died, there is currently no way to revive these cells. But there is ongoing research to discover ways in which to restore vision due to many different eye diseases using stem cells. Although glaucoma is a difficult disease to treat using stem cells, you are young and there is a chance that during your lifetime there hopefully will be a therapy in the future that might help your vision.

Contact lenses are not used to treat glaucoma but rather to correct underlying problems that prevent the eye from focusing properly. There are certainly many prescribed eye drops to treat glaucoma, and I refer you to this website's comprehensive discussion about the various eye drops used to treat this eye disease:

• http://www.brightfocus.org/glaucoma/treatment/common/#medications

There are new contact lenses being developed and are not yet available that release eye medications when they are worn; however, these lenses currently only release medications for a short period of time. Glaucoma is a chronic condition that would require long-term eye medication release, or one would need to change these special contact lenses daily.

I am sorry to hear about your father's glaucoma. Based on your question, I am not certain that I fully understand it, but let me try to tackle it. First of all, visual field testing is quite difficult, not only because it often takes a high amount of concentration and time, but also because it is anxiety-producing. Visual field tests are often unreliable, and there are parameters that the algorithm tests for to indicate whether the test is reliable. Furthermore, there is test to test fluctuation, which may or may not indicate improvement or worsening of the visual field. So, it is possible that some of these factors may be at play as to why the right eye field results are all of a sudden “better” than the left eye field results. It is also possible that the left eye was more damaged all along—glaucoma is a disease that affects both eyes, but often one eye is worse than the other. I hope this answers your questions. You could also accompany your father to his next appointment and discuss these test results with the doctor.

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.