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 right eye became worse after glaucoma surgery four weeks ago. The eye constantly leaks and barely opens. It also feels painful at times like there's something in my eye. The doctor said it's because I have diabetic retina, but if that's the case why did all these problems happen after the surgery? At this point, I cannot see out of my right eye due to the extreme blurriness. [ 11/27/12 ]
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.
In acquired optic nerve pitting and low-tension glaucoma, are there benefits to slowing loss of vision and are there visual acuity advantages to cataract surgery in someone who is 69 years old? The sub-retinal schisis (separation) is at fovea. [ 11/27/12 ]
Thanks for your questions. In terms of your first question, there are certainly benefits to slowing the loss of vision by treating any underlying low-tension glaucoma. This has been demonstrated in several large, randomized controlled trials. Age is not a factor in determining whether there is benefit in cataract surgery as long as the risks of anesthesia and surgery are not too great in terms of your general health and you are willing to undertake the risks of cataract surgery. However, the retinal schisis (which I am assuming is related to your acquired optic nerve pitting) may indeed limit your best visual acuity after cataract surgery. There are some simple tests that can be done in the office to determine what your potential acuity might be after cataract surgery. I would ask your ophthalmologist to perform this testing prior to electing to undergo cataract surgery.
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.
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.
I have applied for disability due to mental illness and eye problems. I recently went for an eye exam and had two hours of testing. What does +1 in both eyes mean? My father had glaucoma in both eyes and my younger brother was just diagnosed with the early stages of this eye disease. Is it possible that I am also getting glaucoma? Thank you. [ 11/27/12 ]
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.