My father, who is 70 years old, had laser treatment for glaucoma, but the eye pressure is still 21. Is this result normal or unusual? [ 10/25/12 ]
Generally speaking, there are two types of laser surgeries that are more commonly used for glaucoma.
One type of laser is used to make a hole in the iris to prevent the possibility of an acute angle-closure glaucoma attack. The purpose of this type of laser is not to lower the eye pressure.
The second type of laser targets the drainage system of the eye and its purpose is to lower the eye pressure. If this is the type of laser your father had, the fact that the eye pressure did not decrease suggests that the laser may not have been as effective as the doctor had hoped. Did your father discontinue his glaucoma drops after the laser surgery? If he was able to discontinue some glaucoma drops after the surgery, then the laser may have had a positive effect. I do counsel my patients that one of the “risks” of the laser surgery is that it may turn out to be ineffective, but because it is a fairly low risk procedure, it may be worth trying first if the patient and ophthalmologist both decide that it is a worthwhile step to take. I would discuss the efficacy of the laser surgery with your father's ophthalmologist at his next visit.
I have had contact lenses for two years and I wear them most the time; I only wear glasses once in a while. When I do wear glasses, they seem not to be the right prescription (they are older than my contacts). Recently I’ve even had to squint sometimes while wearing my glasses, though I’m not sure if it's been like that for a while. Is my eyesight worsening on its own because of glasses that do not have the correct prescription, or is it because of the contacts? [ 10/25/12 ]
It is possible that your eyesight is slowly becoming worse on its own, and not necessarily related to the prescription for your glasses or the contact lenses. Given the fact that your glasses are older than your contacts, it would be worth seeing your optometrist or ophthalmologist for an updated eye exam to see if you need a new prescription for your glasses. Glasses and contact lenses have different prescriptions because of the fact that glasses are further away from your eyes and contact lenses are closer to your eyes.
My mother, who is 71 years old, had a retinal detachment, and also has a diagnosis of glaucoma. The retina was reattached, but now she has developed cataracts and can see very little out of her left eye. If she were to get a corneal transplant, will it restore her eyesight? She was also told that she had optic nerve damage. Thank you for your time. [ 10/25/12 ]
I am sorry to hear about your mother's vision problems. It is not clear from your question whether she has scarring or damage to the cornea that requires a cornea transplant. When ophthalmologists make decisions about surgery, they try to gather as much data to understand what the visual potential is, because all surgery entails risk, and it sounds like your mother might need both cataract surgery and possibly corneal transplant surgery. While cataract and damaged corneas can be replaced and essentially made clear again simply by replacing the lens or cornea, damage to the retina is sometimes not reversible and damage to the optic nerve from glaucoma is generally irreversible. This is because the retina and optic nerve are composed of neurons, which are cells that transmit electrical information. So, I would seek the opinion of a retina and glaucoma specialist to see if they deem the potential vision good enough to recommend surgery.
My son is 24 years old and his eye doctor recently detected slightly higher pressure in his right eye, but didn't seem too concerned. His eyesight had actually improved from the previous year. Is it possible to develop glaucoma and also have your vision improve at the same time? [ 10/25/12 ]
To answer your question about whether vision can improve at the same time one develops glaucoma, it may help to take a step back and discuss the impact of glaucoma on vision. Generally speaking, open-angle glaucoma, which is what the majority of Americans have, does not affect central vision until late in the disease. The earliest impact on vision is generally in the periphery (side vision), which can go unnoticed by patients because one eye's field of vision will overlap with the other eye's field of vision. This is why we ask patients to perform formal visual field testing one eye at a time in the office. You mention that your son is 24 years old, but it is not clear if he is nearsighted, farsighted, or does not wear glasses. It is possible for vision to fluctuate slightly from exam to exam, especially if they are a year apart. Additionally, eye pressure is only one risk factor for glaucoma, so if your son's ophthalmologist is not too concerned about the right eye pressure elevation, then it may be within normal levels of fluctuation. Your son's eye doctor can provide you with a definitive answer.
My left eye feels watery and heavy every other day. Both of my eyes are sensitive to air and lighted rooms. My eyes seem to squint and become watery; however, my vision is fine. What is going on? Do I need glasses? [ 10/25/12 ]
Your symptoms could be due to many different causes and the best way to find out is to see your eye doctor. However, I can postulate some potential causes of your symptoms. One cause is dry eye, which can ironically cause watery eyes and sensitivity to wind. Another may be blepharitis, which is a common chronic inflammation of the glands that line the eyelids, and can result in watery, sensitive eyes. The symptoms of sensitivity in light may be due to cataract, which can cause glare and sensitivity to light despite the fact that vision may seem “normal.” I recommend that you have a comprehensive eye exam and discuss your symptoms with your eye doctor.
I have had glaucoma for several years and eye drops have kept the pressure fairly well controlled. However, my eye pressure increased to 19 in both eyes at my sixth-month exam. My eyes were quite irritated as I have been doing extensive pine sanding lately. Can irritation from sanding cause an increase in eye pressure? [ 10/25/12 ]
I'm glad to hear that your glaucoma has been fairly well-controlled over the last few years. The eye irritation you describe can certainly be due to the extensive sanding. Are you wearing goggles as you work? I would not expect, however, for the sanding to affect your eye pressure. Certainly, one set of slightly elevated eye pressures at a sixth-month visit may not represent a real increase; however, it may be worth having your eye pressure re-checked sooner than another six months from now. Please talk with your eye doctor concerning when he/she would like to measure your eye pressure again.
I had an acute glaucoma attack in my right eye, which recently had a trabeculectomy. I have very little vision in the right eye, which also lost the iris. The left eye had a gonioplasty, which burnt my iris, therefore it has a permanently enlarged pupil of 5 mm, so it can't focus. All kinds of light and glare make it very difficult for me to see. Who do you suggest could best help me with the right prescription as well as recommendations for sunglasses? Should it be a low vision specialist, or a glaucoma ophthalmologist working with a low vision specialist? Do you think they can help me? [ 10/01/12 ]
Thank you for your question. I am so sorry to hear about your eye and vision problems. Not knowing how low your vision is, I would advise you to speak with your glaucoma ophthalmologist about the best resources to use. A low vision specialist can certainly be of great help in improving your vision, such as by prescribing low vision aids, optimizing your home situation, advising you on how best to optimize lighting for reading, etc. There are also contact lenses that may help reduce the glare in your left eye, but it may be more work than it is worth if sunglasses can help you. In summary, I do think you can be helped, and your glaucoma doctor should be able to advise you best. Good luck!
I am 77 years old and was diagnosed with glaucoma three years ago (60 percent in the left eye and 10 percent in the right eye). I manage the glaucoma with eye drops, and I also have a cataract, which does not require an operation. I was diagnosed with the cataract from the age of 45, which never grew; however, whenever I see an eye doctor, he/she always wants to operate on the cataract rather than treat the glaucoma. In December 2011, my pressure was 26 and 27, and in March of 2012, when I went for a checkup, the pressure was 25 and 26. Three months later, I went for a checkup at a different eye clinic, and the pressure was 10 and 11. Can the pressure drop this much in three months? Is this normal? Should I continue taking my eye drops? [ 09/28/12 ]
Thank you for your question. Without having examined your eyes personally and without reviewing the results of past exams and tests, it is nearly impossible for me to give a completely accurate answer. What I can say is that if your eye pressure was in the mid-20s in December of 2011 and March of 2012, and you continued using the same eye drop, it would be rather unusual for the pressure to drop to 10 or 11 in June of 2012 because of the drops alone. If you have been on the same drop regimen from December 2011 until now, eye pressure would not likely change that dramatically. Given that you went to a different clinic, I would wonder if the pressure was accurately taken at one or the other. I would recommend having the pressure taken again relatively soon and determine what the pressure really is. Secondly, I would ask the eye doctor to examine you for any signs of inflammation within the eye. It is always possible that there is inflammation that is decreasing the amount of fluid created in the eye (hence the lowering of the pressure). To reiterate, it is unusual to have intraocular pressure in the mid-twenties on multiple occasions, and then without changing medications have the pressure drop that much. If the readings were accurate, the doctor should be able to help you find a reason for the drop in eye pressure. I would highly advise continuing the eye drops until you can be re-examined by your eye doctor and at that point you can determine whether or not the drops should be continued. Do not stop the drops your own. I wish you the best of luck.