Question:
About 10 years ago I had a pressure spike from narrow angle glacoma. I had a PI done and since then I have experienced no problems at all. The pressure has always been normal.
Three months ago I had an attack in the other eye. A P.I. was done.. but two weeks later I experienced another attack with pressure rising to 60. After the P.I. was checked it was determined that it was not completely opened. So it was redone.
Since then they have put me on 2 drops a day of pilocarpine 2%.
After a recheck they said all was fine and took me off the drugs.
Two days later I began to feel the pressure rise. (all the attacks come in the evening). I gave myself a drop every fifteen minutes and after the fourth drop the pressure stopped.
The next day I went back to the doctors and they told me the PI was fine and the only thing it could be was that the cornea is plateauing covering up the PI. I think they called it plateauitis. I can't find anything written about this problem.
They state they want to keep me off the drops and when an attack occurs they now have to see the eye during the high pressure. I think it is very dangerous waiting in an emergency room with a pressure of 60 waiting for a specialist to see me.
I'm looking for other alternatives. Please help. Thank goodness with all the problems I have had they say that the nerves are still very healthy.
Thank you.... and any more info on the problem I would appreciate.
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Answer:
Danielle,
It seems like you have described attacks of acute angle closure glaucoma. A successfull patent PI reduces the risk of this event recurring almost completely.
If someone does have an attack of sudden pressure rise with a patent PI, then one must consider other possible problems.
Plateau iris is a very uncommon iris shape which can cause the iris to cover the drain even if there is a patent PI. If this is the case, there are a few possible treatments. One could stay on chronic pilocarpine to keep the iris away from the drain. Another possibility is Iridoplasty. This is laser treatment to move the iris away from the drain. This is different from a PI.
It is important to confirm the diagnosis of plateau iris. This is a very rare condition and should be confirmed by a glaucoma specialist.
If there is no plateau iris, then other options must be considered. There could be damage to the drain form the attack of angle closure or there could be an inflammatory cause of the pressure rise.
In any case, it is important for you to keep close follow-up with your ophthalmologist. It is good news that your nerve is still healthy.
disclaimer:
This information is provided for educational purposes only. Please see your physician for diagnostic and treatment options.
If you need further information and are in the Michigan area, you can see the glaucoma specialists at the Henry Ford Hospital by calling 313 916-3260.
Sincerely,
