Question
Hello
You are a very busy person. I am afraid, You will not answer my so many questions. But you are a merciful person. So I will wait for your answers.
Question 1:
I am a patient of primary chronic open angle glaucoma and my anterior chamber angle is narrow. I have severe cataract. I am using glaucoma medicines (Travatan and Betagan), and my I.O.P. is reduced from 37 to 17 mmHg. I will need perimetry after every few months to know whether my visual field loss progression has stopped or not.
Which type of perimetry (White-on-White / Blue-on-Yellow) will be better for me? If, in cataract obstructing view of the retina, neither White-on-White perimetry nor Blue-on-Yellow perimetry can be performed reliably, then how my visual field loss progression can be evaluated? I do not want to remove cataract now, because I want to wait for few years for a combined surgery of cataract and glaucoma.
Question 2:
What are pre-requirements for perimetry? I mean, is evaluation of Visual Acuity and Refraction, necessary before perimetry?
Question 3:
Perimetry result is written on a chart. Many things are written on it. e.g. GHT, PSD, d B, Total deviation, Pattern deviation, False negative errors, False positive errors, Fixation losses, Fovea off, Strategy Sita Fast, Visual Acuity Rx Ds Dc X.
I want to know the meanings of above words. I want to understand graphs on the chart. I want to get deep information of perimetry. I want to get deep information of glaucoma. Is there any website from where I can read such deep information?
Thank You,
Best regards,
Allen.
Answer
Dear Allen,
Chronic OPEN ANGLE glaucoma and narrow anterior chamber angle cannot go together !! They are mutually contradictory !!
We need to know vision, pupillary reactions, angle structures(goniscopy) findings, disc findings and reports of previous perimetry tests done to be able to guide you better.
There is no logic of waiting to do the cataract surgery to combine with TRAB; in fact the longer you wait to do cataract, the more riskier the surgery later as the cataract gets harder.
You need to follow the advise of a good eye specilist who is specialized in both cataracts and treats glaucoma.
You may read about glaucoma on www.shroffeye.org
Hope this helps,
Best,
Dr Shroff
www.shroffeye.org
