Yes, let them know, so that they can advise you about possible effects on the eye of any prescribed medications and vice versa.
I suggest your family doctor or optometrist refer you to an ophthalmologist for a full glaucoma assessment including an eye exam, optic nerve imaging and visual field testing. This will help make the correct diagnosis and determine the best way to lower intraocular pressure (IOP) – the only treatment for glaucoma.
No – there is no clinical evidence that a warm compress will reduce IOP either by reducing aqueous production or enhancing aqueous outflow.
All steroid medications can potentially cause eye pressure elevation and lead to the development or worsening of glaucoma. The most common steroid medication that causes eye pressure elevation is topical steroid eye drops instilled directly into the eye, followed by topical steroid creams applied around the eyelids, and by orally ingested steroids.
Inhaled steroids for lung conditions and steroid nasal sprays and creams applied to body parts are less likely to cause elevated eye pressure, but I recommend getting your eye pressure checked about 2 weeks after starting any steroid medication to see if it has an effect on you. Please note glaucoma patients are especially at risk of a pressure spike with steroid use.
No treatment or medication has been proven to stimulate blood flow to the brain. Gingko Bilboa has been studied but no clinical study has proven that it works. Stem cell research is still experimental and not available for clinical application. Some people who have sought stem cell treatment in unregulated clinics have had bad outcomes.
Although promising, the Eyetronic procedure and study have been done in only one site in Germany and have not been validated with a second study or by an alternate site. Usually before any treatments become accepted, they are tested in multiple sites and have multiple studies to validate that the treatment works. One must be very careful when a clinic touts a procedure that a patient has to pay for and is the only clinic to report the procedure’s success.
One of the most common causes of blurred vision is refractive error (sometimes from cataract development), so updating your eyeglass prescription may help. Dry eyes (ocular surface disease) from increasing age and from medications such as Lumigan can also contribute to blurred vision, so you might try using artificial tear drops.
It is difficult to know from this question if the vison loss described is a consequence of the transplant surgery or the glaucoma or both. Unfortunately, loss of vision from glaucoma alone does occur even with the best treatments. Glaucoma is a progressive condition, treatment only slows the progression. There is no cure at this time.
The use of baby shampoo or eye make-up remover is for the treatment of Blepharitis – an inflammation of the eye lashes. Either use hot compresses for 5 minutes or lid scrubs (analogous to removing eye make-up). You can use them undiluted, but there may be less stinging and eye irritation when diluted.
I suggest trying just a drop on the finger first – if it is too irritating for the eye then dilute it with some water. No formula, just add enough water so it stays soapy but not irritating.
Overall exercise can lower eye pressure, but avoid any activity that can raise the pressure around the face. This includes heavy weight lifting, certain yoga positions such as downward dog and headstands, and playing wind instruments.
I recommend talking to a personal trainer who can advise you on a program that mixes light weights with cardio to maintain both strength and fitness.
We usually start with a prostaglandin medication or a beta blocker. Side effects are generally minimal in healthy adults but can affect the eyes – red eyes, stinging, allergic reaction – or the body – headache, slow heart rate or gastrointestinal upset. The other option is laser treatment, but it may not work or its effect may not last, requiring eye drops in the future.
No. Low eye pressure happens because the faucet of the eye turns off (ciliary body shut down). This can be from injury or post-operative inflammation. Usually it restarts over time. Eye inflammation can be controlled with a topical steroid eye drop. Topical atropine drops may also help.
Both eye drops and surgery are ways to control eye pressure. Surgery may have complications such as bleeding, infection and loss of vision. The recent Collaborative Initial Glaucoma Treatment Study (CIGTS) comparing early surgery to eye drops showed very little difference between the two groups in final outcomes for glaucoma control. But more side effects were noticed in the surgical group.
For early cases, we are looking at surgical techniques such as iStent, Xen, Infocus, and Hydrus as ways of controlling eye pressure with minimal eye trauma and better success for the patient without the use of eye medications.
This type of unsolicited chain email has no basis in scientific fact. No evidence links smart phone use to early onset macular degeneration, glaucoma or cataracts.
The mechanism of the glaucoma determines the best treatment. The main cause for angle closure is pupillary block where the lens and the iris are in contact so fluid cannot flow from behind the eye to the drain of the eye that is in front of the iris and lens.
In this case, treatments include eye drops to lower eye pressure, pilocarpine to constrict the pupil, laser or surgical iridotomy to open the angle and cataract surgery to remove the large lens.
Sometimes if the eye pressure is not controlled, conventional glaucoma surgery is used.
Recent studies from China have shown that cataract surgery is beneficial in managing closed angle glaucoma.
Sleeping with lots of pillows simply tilts the head forward bending the neck. This bending may not help with lowering eye pressure. It’s important to raise the head of the bed so your head is raised above your heart without bending your neck. This has been shown to lower eye pressure in some patients. Placing pillows under the mattress to raise the head of the bed by a few inches is one way to achieve this.
If you have moderate to severe glaucoma, IOP control is very important. We usually recommend an eye pressure at least 50% below the untreated number and/or <15 mm Hg. Probably despite all the eye drops you are using, you are still not at target eye pressure and that is why the doctor is recommending laser treatment and/or surgery.
These could be signs of glaucoma but you are a bit young. Lengthy time spent on a computer can cause dry eyes and eye fatigue. I suggest you get a complete eye exam to rule out glaucoma or anything else that may be causing these symptoms.
Acupuncture has no benefit on eye pressure, although it may help alleviate stress and anxiety.
Loss of vision can range from mild vision blur to complete loss of sight meaning unable to see light or dark.
The risk to the second eye depends on the eye pressure. If it is controlled, the risk is usually minimal. Monitoring the visual field test will determine if the second eye is getting worse. However, it is imperative to listen to your ophthalmologist, keep follow-up appointments and use the medications prescribed to control the eye pressure.
Ocular Hypertension occurs when the eye’s pressure is elevated (greater than 22) but there is no damage to the optic nerve or visual field.
Many years ago, patients with eye pressure greater than 22 were treated for glaucoma.
The Ocular Hypertension Treatment Study concluded that not every patient with elevated eye pressure needed treatment. In the study, some patients worsened despite treatment and over 80% of untreated patients did not worsen.
The study found other risk factors that contributed to glaucoma and these factors combined with elevated eye pressure may indicate the need for treatment.
You had a subconjunctival hemorrhage. This can happen with coughing or sneezing and is also associated with the use of blood thinners such as Aspirin or Coumadin. Most are of no concern, resolve in about a week, and have no effect on your glaucoma.
We can’t estimate time to vision loss. Each patient progresses at their own rate although it’s a good sign when there is no progression over the years. Treatment will help maintain vision and slow progressive vision loss in most cases. The Normal Tension Glaucoma Study shows a 30% lowering of eye pressure slows the worsening of glaucoma.
Working on a computer all day will have no impact on the worsening of your glaucoma. No studies have shown that stress worsens glaucoma, but many ophthalmologists have found that eye pressure may be elevated during periods of stress. This may be due to poor compliance with eye drops use. The best way to minimize worsening of glaucoma is to use your drops and attend your regular follow-up appointments.
Although glaucoma tends to run in families, it does not affect all family members equally. Your overall risk increases with the more first degree relatives (parents, siblings) affected by glaucoma that you have. If you have family members with glaucoma, you should be screened regularly.
Patients frequently ask their doctors the question “Do I have glaucoma?” To reply, I need to do a complete eye exam as well as visual field testing. Additional tests such as HRT (Heidelberg Retina Tomography) and OCT (Ocular Coherence Tomography) may help me answer. I often tell patients that to truly say one has glaucoma, we must document characteristic optic nerve head changes and/or visual field loss during the first exam or follow-up appointments. We must also see signs of worsening of the optic nerve or visual field over the follow-up period. It may take many years before changes are found.
Some new formulations of existing medications are now available including:
These various medications may either reduce eye drop side effects or reduce the frequency of eye drop use.
Surgically, new treatments include:
All these surgeries aim to lower intraocular pressure and reduce eye drop use.
Researchers have found Cannabinoid receptors in human eyes. Cannabinoids are the active ingredient in marijuana and help to lower eye pressure. Their action is short lived so you would have to smoke marijuana constantly to have any long-term effect in lowering eye pressure. This would result in a constant “high” which would be unsafe. Also smoking marijuana has significant health risks including lung cancer. Using marijuana to treat glaucoma is not recommended.
Patients with advanced glaucoma may not meet the legal requirements to drive. The current regulation is to maintain 20/50 or better vision in at least one eye and have at least 120 degrees of continuous visual field. Because glaucoma can affect peripheral vision, many patients with advanced glaucoma may have 20/50 or better vision but they do not have enough continuous visual field. In Ontario, physicians must report this by law. This may result in a suspension of your licence.
Normal tension or low tension glaucoma is a condition where there is damage to the optic nerve and/or the visual field in the setting of normal eye pressure (<22). More than 50% of normal tension glaucoma patients don’t worsen even without treatment so it is okay to watch.
Other things can mimic glaucoma field loss. These include a “stroke” to the eye which can cause a similar visual field defect, previous eye trauma with damage to the retina, or, more rarely, a brain tumor.
Not all glaucomatous visual field defects are from the sides. Quite commonly with low tension glaucoma, many defects may be top or bottom.
Raynauds Sx and migraine are commonly associated with normal tension glaucoma as is low blood pressure and major blood loss.
There is more of an association of glaucoma worsening with low blood pressure than with high blood pressure. Certain blood pressure medications, such as diuretics (water pills) or calcium channel blockers have been associated with glaucoma worsening, but the data to support this is still limited.
Diet and weight loss do promote overall general well-being and obese people may have higher eye pressure readings.
Smoking has been shown to affect glaucoma surgical outcomes in a negative way and patients are encouraged not to smoke.
No, weight lifting such as bench pressing has recently been reported to temporarily increase eye pressure.
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.
Yes, a recent study has shown that if you have a sibling with glaucoma you have a significant risk of developing optic nerve damage.
No, not all glaucoma patients are elderly. In fact, 25 percent of patients are under 50 when they develop the disease.
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.
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.
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.
There is no scientific evidence suggesting that emotional stress affects intraocular pressure.
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.
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.
Darker, thicker eyelashes are a common side effect of all Prostaglandin medications – Lumigan, Xalatan and Travatan. There is no way to avoid this. It does reverse itself once you stop the medication but it can take a few months to return to normal.
Some people also notice some darkening of the skin around their eyes. You can minimize this by avoiding skin contact. Put the drop in about an hour before you go to bed, gently wipe around the eye with a damp tissue and rinse your eyes just before bedtime.
Osteoporosis drugs have been linked with uveitis. Discontinuing osteoporosis drugs is usually the best management for uveitis.
The use of these medications does not directly cause glaucoma to develop or worsen. However, if someone develops uveitis, the treatment is topical or oral steroids. Long term use of steroid medications can cause eye pressure elevation and the development of glaucoma. This is less likely to occur if you are under the care of an eye specialist who monitors your condition.