I have glaucoma and had a trabeculectomy in my right eye, which resulted in double vision. Glasses are required to correct that symptom. I also have had laser treatments on both eyes and the pressure is still between 12 and l6. My current problem is the inability to see when I come in from the outside; for about five minutes I seem to be standing in a dark pit until my vision adjusts. Could a retina specialist help with this rod and cone problem? [ 02/25/13 ]
The problem you describe must certainly be very frustrating. I certainly think that seeking the expertise of a retina specialist to assess whether you have a retinal disease that is causing your symptoms is reasonable. However, I would first bring these symptoms up with your ophthalmologist or glaucoma specialist. Sometimes the symptoms you describe can be due to cataract. Another possibility is if you are on glaucoma medications that constrict your pupil. If your ophthalmologist feels you would benefit from a retina consultation, then he/she can refer you to a specialist.
I drink far too much coffee and have just found out that this could be a cause of glaucoma. [ 02/25/13 ]
Thanks for your question. Studies have shown that consumption of caffeine causes transient elevation of eye pressure in patients with glaucoma and ocular hypertension. Additional population studies report higher intraocular pressures in glaucoma patients who regularly drink caffeinated beverages as compared to those who do not. Thus, most glaucoma doctors recommend avoiding heavy consumption of caffeine.
Our website has excellent information concerning glaucoma risk factors.
I have been found to have 50% “PSA” in my right eye and I do not want laser surgery. My only vision problem is farsightedness. If I do nothing will I absolutely get glaucoma? Why can’t the eye drops manage this problem? I am terrified of the laser procedure and I worry that I could have permanent harm from the surgery. What are the alternatives? [ 02/25/13 ]
Thank you for your question. I am not sure what “PSA” refers to, but perhaps you are referring to “PAS,” or posterior anterior synechiae. These are abnormal adhesions from the iris to the “angle” that are one cause of chronic angle-closure glaucoma. Your farsightedness is one risk factor for having narrow angles, and the suggested preventive treatment for an angle-closure attack is a laser iridotomy, which creates a hole in the iris and allows an “escape route” for fluid to drain from your eye. Drops generally cannot manage the problem; however, sometimes ophthalmologists consider the use of topical pilocarpine to make the pupil small, but this does not always prevent an angle-closure attack.
When I counsel patients who need this laser iridotomy procedure to prevent an angle-closure attack, I weigh the risks and benefits. The benefit of preventing an angle-closure attack is enormous, and the damage from such an attack is quite profound and irreversible. The risk of laser surgery is quite small in comparison; sometimes there is an eye pressure spike so patients will wait for 30-60 minutes after the surgery to ensure this does not happened. Because we are making an additional hole in the eye for light to pass through, some patients complain of glare or haloes, but this is not common. The alternative is to do nothing, which is an option. No one can predict with great accuracy whether you will have an angle-closure attack in your lifetime. The risk likely becomes greater as you get older, because your lens (I am assuming you have not had cataract surgery) will also thicken, making the angle even more narrow. I would recommend that you make a follow-up appointment with your ophthalmologist and discuss the risks, benefits, and alternatives of the procedure again before making your final decision.
My eye pressure readings are 19 out of 20. What can I do? Should I be on eye drops now? I am 46 with hypersensitive dry eyes. [ 11/27/12 ]
Thanks for your question. Unfortunately, I do not have enough information to adequately answer your question. An eye pressure of 19 mmHg is actually within normal limits, but that does not mean you do not have glaucoma. Eye pressure is one significant risk factor of glaucoma, but does not determine whether you have glaucoma or not. I would recommend that you see an ophthalmologist, if you have not already done so, to determine whether you truly have glaucoma and thus should be treated. For your dry eyes, I would recommend that you first try over-the-counter artificial tears to see if this helps with your symptoms. If you also have seasonal allergies or itching is a major component of your symptoms, your eye doctor can talk with you about other types of eye drops that may be beneficial.
I have been treated for seven years for glaucoma with eye drops due to allergies. My eye doctor sent me to a surgeon because I did not do well on a field vision test. The specialist said that he does not believe that I have or ever had glaucoma. I am very confused. Have you heard anything like this? [ 11/27/12 ]
Thanks for your question. I am not sure what your treatment of “eye drops due to allergies” means, but in answer to your main question, it is possible that you were treated as a glaucoma suspect as opposed to someone who has definite glaucoma. I have many patients in my practice who are glaucoma suspects, and over time the patient either develops glaucoma or simply remains a glaucoma suspect. It is possible that you had certain risk factors that prompted your first eye doctor to begin treatment with eye drops, but after reviewing your tests and examining your eyes your second eye doctor does not believe you have glaucoma. I know this may be frustrating, but this is why I always emphasize follow-up with my patients who are glaucoma suspects. Often the diagnosis of glaucoma is very clear and definite, but other times the diagnosis is less certain.
I was diagnosed with buphthalmos when I was six months old and had surgery on both eyes. I got my vision back in the right eye when I was still a baby, but they could not do anything for my left eye. Is there any chance that I can get my vision back in my left eye? I am 18 years old now. [ 11/27/12 ]
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.
Is it necessary for me to take timolol maleate and latanoprost eye drops if I am 82 years old and have glaucoma and cataracts? [ 11/27/12 ]
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.
I experience pain in my eyes when I go outside in the daylight; it is also difficult for me to see things because they are not clear and are out of focus. Are there any treatments that can help? [ 11/27/12 ]
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.