Glaucoma questions - Eye & Vision Message Board

wring · 05-22-2009, 04:00 PM

I was a 'glaucoma suspect' for about 15 years, have been diagnosed/treated for the past 5, have tunnel vision now. I'm on my 5th treatment plan in this time. first plan (eye drops) worked for about 2 months til I developed a reaction to them, switched drops, my eyes failed to respond to that drug, switched drops again, that was fine for about a year, then I started developing a resistance to it, so they added a second eye drop, that's worked for about 2 years. Now, they've seen more damage, so had SLT's done in both eyes.

Question 1: I understand that glaucoma can be tricky to treat, but are they going to run out of options soon? I"m too young (early 50's) to lose my sight entirely.

Question 2: for quite a while now (last 3 years or so), I know I have blind spots on the periphery. But as I'm sitting in the living room or whereever, I often get the visual sensation that something just out of the reach of my vision is moving, I move my head and .... nothing. Is this normal?

Thanks.

KeelaC · 05-23-2009, 10:13 AM

Question 2: The brain does weird things in areas of missing vision. People with central vision loss can have a condition called Charles Bonnet Syndrome where they see all kinds of things that aren't there.
This probably doesn't apply to you because glaucoma damages the optic nerve, not the visual cortex in the brain; however, the visual cortex handles different aspects of sight in different areas. Movement is detected separately from colour, say. I read about a stroke victim who had no vision whatsoever because of damage to part of his visual cortex. But if something moved in front of him he could tell in what direction the movement was. He couldn't see anything. Isn't that fascinating?

thirdeyeguy · 05-24-2009, 05:44 PM

Quote:

Originally Posted by wring

I was a 'glaucoma suspect' for about 15 years, have been diagnosed/treated for the past 5, have tunnel vision now. I'm on my 5th treatment plan in this time. first plan (eye drops) worked for about 2 months til I developed a reaction to them, switched drops, my eyes failed to respond to that drug, switched drops again, that was fine for about a year, then I started developing a resistance to it, so they added a second eye drop, that's worked for about 2 years. Now, they've seen more damage, so had SLT's done in both eyes.

Question 1: I understand that glaucoma can be tricky to treat, but are they going to run out of options soon? I"m too young (early 50's) to lose my sight entirely.

Question 2: for quite a while now (last 3 years or so), I know I have blind spots on the periphery. But as I'm sitting in the living room or whereever, I often get the visual sensation that something just out of the reach of my vision is moving, I move my head and .... nothing. Is this normal?

Thanks.

You still have a lot of options. Unfortunately drift, or loss of effectiveness is not all that uncommon with a lot of medications. If you shifted drops in the same class of drugs (like from lumigan to zalatan), there would not usually be to much benefit. But there are a number of drugs that work by different mechanisms. SLT is a great procedure because it can be repeated a number of times if it starts to fail. If you pressures are not controlled to the point that prevents you from losing vision filtering bleb surgery will drop the pressure down to a very good level. The understanding of glaucoma is shifting and starting to be viewed as a blood flow problem to the optic nerve and less of an elevated pressure problem. You will probably see drugs in the near future that are neuroprotective and may be a great advance in the treatment of glaucoma. There are some nutrients and supplements that may also offer some neuroprotection benefits. What you are seeing to the side sounds more like a vitreous floater-ask your eye doctor. Best of Luck!

wring · 05-26-2009, 09:44 AM

Thanks - changing treatment plans makes me feel like it's not controlled, hopeless. your answers has helped assuage that fear. I have follow up to my second SLR Friday, hopefully will have good news.

thirdeyeguy · 05-27-2009, 09:39 PM

One other thing you might check on- there are a few cases of Alphagan (Brimonidine) glaucoma drops possibly causing Charles Bonnet Syndrome. That is extremely unlikely and could be coincidental but if you are taking Alphagan you could have you eye doctor look into the possibility. I would not expect them to be aware of this without research, I certainly was not.