GLAUCOMA

Question

I SENT A NOTE EARLIER ABOUT MY 80YEAR OLD MOTHER WITH GLAUCOMA . COULD A BETA BLOCKER FOR HIGH BLOOD PRESSER INSTEAD OF THE DIURTETIC SHE IS ON HELP WITH THE PRESSER IN HER EYES. ALSO SHE HAS HAD CATERAC SURGEY ON BOTH EYES. SHE IS A WONDERFUL MOTHER AND I WANT TO HELP HER ANY WAY I CAN. AGAIN THANK YOU FOR ANY HELP YOU CAN PROVIDE. CAROL

Answer

Systemic beta blockers may have an effect on the eye pressure but this is usually not of great significance. The reason is because the topical drop will allow for a much greater concentration in the eye. The systemic drug will not allow for such a high concentration. There are many good options out there nowdays.

This information was provided for educational purposes only.

Extensive reading & glaucoma

I am 62, am being treated for minimal case of Glaucoma, have bifocal (continuous) glasses with a current prescription. I am retired and do a lot of reading. After 2/3 hours, I have to give up because of poor focus. This lack of focus yields a vertical displacement but no horizontal displacement for images near or far. It takes about an hour for my eyes to get back into focus. Varied use of my eyes, driving, TV, etc. yields no distortion at any time during full days.
My ophthalmologist gave me a quick answer- nothing can be done, this is normal.
I really enjoy reading and would like to extend the available time. There must be some things that can help: dedicated reading glasses, eye exercises, more/less light, reading position/distance. Any suggestions ?
Thanks, Dave

Answer
As we get older, we sometimes develop some double vision if we have trouble keeping our eyes focused together. It takes some effort to do this and it is done automatically. As we get older there is a greater tendency for tis to occur. It sounds as though you are having vertical double vision. It is also possible that you develop some difficulty with one of the nerves that controls the muscle - this should be evaluated by your ophthalmologist. It is possible to get dedicated reading glasses if this is when this occurs. Prisms can be put in the glasses to compensate for this tendency. You may want to see an ophthalmologist who specializes in treating eye muscle disorders.
This info was provided for educational purposes only. Call 8003637575 to arrange an appt with one of our Henry Ford Ophthalmologists.

Humphrey Field Analyzer-correct setup & test procedures

Question

The results of my computerized field tests seem to vary drastically based on skills/interest of the technican setting up the test. I would like to verify if the test is being poorly given or poorly taken by me.

I am trying to find out "how to use the field analyzer in clinical practice, including specific directions & instructions for technicans & patients." One source is the book by N.T.Chopin, R.P.Edwards.

Thanks, Dave

Answer

You are right. There are several variables which can affect the field outcome. The machince must be properly set with the proper correction used for your glasses (if any). This correction also has to be placed in the correct position. The technician must moniter the test to make sure the machine is working well and that you are paying attention. If the patient looks away are is not performing the test correctly, the technician can identify this and remedy it.

The results are also matched with age controls so if the incorrect age is entered, the statistical analysis is wrong.

The best source is the handbook which acommpanies the field analyzer. I am not sure how you can get one other than maybe borrowing it from your physician's office.

This information is provided for educational purposes only and you should maintain followup with your ophthalmologist.

Follow Ups:

Drops or don't drops

Question:

I've had my eye pressure taken twice- one eye is 26 and the other was 16. Field of vision normal. No family history of glaucoma. diagnosis ocular hypertension. recommended I put a drop of tiloptic .5% in the 26 eye twice a day. I have read that you are doing a study on treatment for ocular hypertension and would like to know if you recommend I start treatment or wait and go for frequent review of the condition?

Answer:

Yes we are involved in a multicenter study of ocular hypertension but the study is not yet concluded so the results are not available. You did not give me other information such as the look and size of your optic nerves. Have you had an injury to this eye as a child? You certainly do not have to treat a pressure of 26 as long as you follow the optic nerve, pressures, and field, but sometimes the whole clinical picture may make me more likely to treat. I know some glaucoma specialist who treat any pressure over 27 regardless of the picture because there is some risk of vascular oclusions and increase risk of glaucoma over time with such pressures. If you were to use drops, I personally would recommend a non-beta blocker or a 0.25% solution than can be used once a day.

Good luck. This information was provided for educational purposes o

eye examination

Question:

How frequently should I have my eyes examined?

Answer:

Many factors will influence the frequency of your eye examination, and the optometrist will weigh these factors in deciding when you should be seen again. However, the Canadian Association of Optometrists has established general guidelines which can assist you in determining the need for follow-up examination.

CAO recommends that Canadians have their eyes examined along the following minimum recommended guidelines:

• Infants and toddlers (birth to 24 months) - By age 6 months

• Preschool (2 to 5 years) - At age 3, and prior to entering elementary school

• School age (6 to 19 years) - Annually

• Adult (20 to 64 years) - Every one to two years

• Older adult (65 years and older) - Annually

Question:

My eyes feel fine and my vision is 20/20. Why do I need an exam?

Answer:

20/20 does not mean your eyes are healthy. Often serious eye disease presents itself with no warnings or symptoms. An optometrist knows your eyes inside and out and a comprehensive eye examination gives you information about the health of the eyes, and can also offer indications about diseases that also affect the whole body, like diabetes and hypertension.

Glaucomatocyclitic Crisis

Question：

Posted by Amy

I am a 27 year old female. When I was 14 years old I was diagnosed with Glaucomatocyclitic Crisis in my right eye. I have had a laser procedure and 2 filtering bleb procedures done. Though I have substantial vision loss in my eye, my pressure has been 10 and stable for close to 5 years.

My doctors at that time said that my type of glaucoma is very rare and that the chances that I would get it in my other eye is very unlikely. After 13 years of first being diagnosed with this I now have it in my left eye. I have gone to see my specialist and he has stated that though I have a right to be concerned he is confident that this will disappear the older I get.

My questions are:

1. Do studies show that the older a person gets the less likely they will have continued problems with this?

2. What causes this disorder?

3. Are the spikes in pressure stress related?

4. How rare is this disorder?

Answer：

Posted by hfhs md - NI

Glaucomatocyclitic crisis is an uncommon form of glaucoma which usually affects one eye. If it is affecting both eyes, another diagnosis should be considered such as an alternate inflammatory glaucoma.

We are not aware of the cause of this disorder but it is related to inflammation in the eye. It is usually a self limited process which can have some recurrences. Damage to the eye from this form of glaucoma is unusual.

You should see a glaucoma specialist to evaluate your glaucoma and confirm the diagnosis.

This information is for educational purposes only.

Episodic Glaucoma - Mishapen Pupil

Question：

Posted by Mike

I have just had an acute episode glaucoma ， which may gradually resolve itself. I am now being treated for this with intraocular pressurePressure ulcer reducers.

I have noticed that my pupil is now mishapen and is no longer round, and is larger than my other pupil. My visualVisual acuity test acuity in the affected eye is now worse than it was.

What could have caused this and will it naturally resolve itself?

If not is there some procedure to correct this?

Answer：

Posted by HFHS MD

The most common type of acute angle closure glaucoma. I am not sure if this is what you had but I will assume so. In this condition, the eye pressure suddenly becomes very high. This can cause eye pain, headaches, red eyes and reduced vision. The pupil also does not function properly. Different people have different degrees of symptoms.

Depending upon the extent of pressure elevaton and its duration, there can be permanent damage to the eye. I cannot comment in your particular case. If this is angle closure, you may need a laser treatment to help prevent a future attack and also one in the fellow eye to prevent an attack in that eye.

You should discuss your case with your ophthalmologist and have him explain your condition in a detailed manner to your satisfaction.

This information is provided for educational purposes only.

Test for glaucoma

Question

I'm 55 yo caucian with a history of maternal glaucoma. Made an appointment with an opthomolagist. There testing method is done by a computer determination rather than the common pupil dilation method. Will you comment on this computer method in term of accuracy and diagnosis reliablity?

Answer:

I assume you are referring to a computerized visual field test. This is the common form of visual field testing today. This tests your peripheral vision which can be affected in glaucoma. This should be performed in conjunction with a dilated examination. The clinical evaluation of the patient is critical as well. This is where the pressure in the eyes is determined along with evaluation of the optic nerves. You chould clarify this with the doctors office.

This information was provided for educational purposes only.