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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.


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.


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.


My dad is 72 and he was diagnosed with glaucoma in the right eye, in which the pressure varies between 14 and 17. During follow-up visits he had the visual field test for both eyes. Please note there were also three field test done only for the good left eye. Now to my surprise, the damaged right eye field test results were better than the left eye. The doctor says there is no cataract. I am wondering what the problem could be? Any help or guidance would be quite helpful. [ 11/05/12 ]

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.


Do treatment options for glaucoma include contact lenses and prescribed eye drops? [ 11/05/12 ]

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:

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 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.


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.


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Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

Last Review: 04/28/13


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