Questions & Answers
Reprinted from Our Newsletters
General
Can I lift weights if I have glaucoma?
No, weight lifting such as bench pressing has recently been reported to temporarily increase eye pressure.
Does wearing sunglasses help glaucoma?
A recent report suggests that certain wavelengths of light could be bad for the optic nerve. This hasn’t been proven yet but it would be wise to wear sunglasses and a hat on very bright days.
Does having a sibling with glaucoma increase my risk of getting it?
Yes, a recent study has shown that if you have a sibling with glaucoma you have a significant risk of developing optic nerve damage.
Do only elderly people get glaucoma?
No, not all glaucoma patients are elderly. In fact, 25 percent of patients are under 50 when they develop the disease.
What is the difference between glaucoma and ocular hypertension?
Glaucoma refers specifically to high pressure causing damage to the optic nerve and/or peripheral vision. Ocular hypertension refers to high pressure which does not damage the nerve or vision. Most patients with ocular hypertension do not develop glaucoma.
I see very well and do not wear glasses. How can I have glaucoma?
Glaucoma affects side vision first, and only affects central vision very late in the disease, so it has no effect on your need to wear glasses.
Can vision deteriorate despite treatment for glaucoma?
Yes, as part of the normal aging process, we lose cells in the optic nerve responsible for vision. Currently, there is very little that can be done about this change due to aging.
Patients with severe damage from glaucoma will be more aware of this progressive loss of vision. That’s why it’s essential to diagnose glaucoma early before damage occurs to the nerve cells.
Does emotional stress affect my intraocular pressure?
There is no scientific evidence suggesting that emotional stress affects intraocular pressure.
What does a hemorrhage on my nerve mean?
In glaucoma, a small hemorrhage on the rim of the optic nerve indicates that eye pressure is too high for the nerve. Your eye specialist will usually recommend lowering your pressure to a safer level with eye drops, laser treatment or surgery.
If my blood pressure is high will my eye pressure be high?
Not necessarily. Although there is an indirect relationship between high blood pressure and glaucoma in older patients, patients under stress or who experience a sudden increase in blood pressure do not usually have high eye pressure.
Does eye strain cause glaucoma?
No.
Research
What about Glaucotab, a herbal treatment that I found on the Internet?
Do not use it. It has no scientific validity and should not be used until it is shown to work and not to be toxic.
Diagnostic Tests
What is HRT?
A fast scanning laser ophthalmoscope called a Heidelberg Retinal Tomograph (HRT) produces a 3-D image of the optic nerve so specialists can diagnose damage early on. HRT can also detect early progression of glaucoma caused by nerve damage.
Medications
What if I forget to take my eye drops?
Take them as soon as you remember. Every time you forget to put an eye drop into your eye, your eye will have no medication to control the pressure. The pressure may increase, causing more damage to your sight. To control your glaucoma, you must apply drops regularly according to your doctor’s instructions.
Can I miss the occasional eye drop?
No. Your eye needs consistent medication to control the pressure and prevent blindness. Every time you miss an eye drop, eye pressure may increase, causing further damage to your sight.
How can I avoid side effects?
Two things will help. Keep your eyes closed for 3 minutes after putting in your drops. Apply pressure to the side of your nose (where your upper and lower eyelids meet) to prevent the drops from entering the nose from your tear ducts.
What about contamination?
Always wash your hands before applying eye drops. Do not touch the dropper tip or let it touch your eye, eyelashes or any other surface. Always close the bottle when finished.
I use 3 eye drops. Can I put them in all at once?
You should wait at least 3 to 5 minutes between drops. This prevents them from being diluted and lost in teardrops.
Does the order of the drops matter?
If you are taking TIMOPTIC-XE®, it should go in last.
Do eye drops cause cataracts?
Today’s eye drops probably don’t cause cataracts. Some of the older drops such as Phospholine Iodide may predispose patients to cataracts. Doctors tend not to use these very strong drops in patients with a normal lens.
Surgery
My doctor has recommended laser treatment for glaucoma, how well does it work?
Because it can be difficult for patients to use multiple eye drop medications and because of less damaging side effects with current laser treatment, we are using laser treatment earlier.
Selective Laser Trabeculoplasty (SLT) has a pressure lowering effect of about 20% – comparable to adding another medication. Laser however, is not a “cure” for glaucoma – it doesn’t always work, its effect may not last, and your ophthalmologist must still continue to monitor your eye pressure.
I need glaucoma surgery, what are my options?
The surgery of choice for glaucoma is a trabeculectomy. This procedure has been used for more than 30 years and has a proven track record. Recently, a study has shown that a tube shunt operation (Seton) has similar efficacy to the trabeculectomy and possibly less side effects. The tube shunt was traditionally reserved for complicated glaucoma cases or cases that had previously failed a trabeculectomy.
Why can’t the eye grow new nerve cells to replace the ones damaged by glaucoma?
The eye is made up of sophisticated nerve cells that are an extension of the brain and are incapable of regenerating when they are damaged. Currently, we are only able to regenerate certain neural cells in laboratory conditions. We are looking at medications that may help damaged cells survive longer or prevent the damage altogether.