Visual Impairments

Hi. My name is Dee and I'm a frequent flier of the Arthritis and Worker's Comp & SSDI Support boards as well as becoming a regular on the Diabetes board.

I was diagnosed 2 months ago with diabetes and since I got no input or help from my physician I switched doctors and saw my new one last Thursday. The first thing he did was make me an appointment with an opthamologist who's also a retinal specialist. I went to him yesterday and he was concerned because of an asymmetry in my optic nerves. He also said my pressures were a little high. Good news is no diabetes in the eyes. He sent me to a glaucoma specialist and I went this morning.

Today's appointment I had my pressures measured twice and a peripheral vision test. After testing and examining me for 2 1/2 hours I was told:

1. Optic nerve is has a thinned boarder which indicates glaucoma. Right thinner than left.

2. They did one of those tests with the flashing lights that test peripheral vision. I had a problem in 2 spots in one quadrant of the right eye which is where glaucoma changes usually start

3. Pressures are boarderline. They checked them twice and he said 20-21 is high, mine are 19-20 which is boarderline.

He measured the thickness of my corneas and said they were thick which is in my favor. He also said the pressures can fluctuate throughout the day and since I had them measured about the same time yesterday as today I'm to go back in a month in the early AM when the pressures are usually higher to see what they are. In the mean time I signed a release to try to get any records from my previous eye doctor in Chicago (I'm a transplant to Alabama) to see if he has any previous pressures and hopefully pictures of my optic nerve so he can see if this is just normal for me. He's not willing to say I have glaucoma yet.

He gave me a couple of options whether he feels it's glaucoma or not.

Start on drops to decrease the pressure or laser surgery to open the ducts and decrease the pressure. He feels the pressure needs to be decreased either way just to prevent any damage. We're not making any decisions either way until my next appointment but he suggests the surgery since it's 80% or 88% effective and it's a one time procedure over using drops daily for the rest of my life. I'm trying to get as much info as I can about the procedure, pros and cons of surgery over meds.

Has anybody had the surgery and if so would you recommend it?

Thanks for any info or input.

Dee

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Hi, Dee!  I'm Barbara, the cl- for VI.  I've had glaucoma for years which was only diagnosed in 2002.  You are fortunate to get an early diagnosis even if it is not 100% certain.  It sounds like they are talking about open-angle glaucoma, the one that makes you blind painlessly.  Narrow-angle is less common and has nasty symptoms. 

It's normal to have different pressure in each eye.  My pressures were in the mid to high 20's before I started treatment.  The left eye responded to drops, but the right eye didn't, so I had a rather invasive procedure called an Aquaflow Drainage Device implanted on the top of my eyeball.  That caused a traumatic cataract, so I had that removed, a lens implanted and now, 6 years later, I have about a 40% vision loss in that eye and the pressure has settled at about 9 to 11.  If the eye is a clockface, my loss is the area between 6 and 11pm.  Does funny things to my depth perception, but I have learned to compensate for the most part. 

The left eye pressure runs about 14-16 on daily Xalatan drops.  On occasion, the pressure has slowly climbed and when it reaches 18 or higher, we have done a laser treatment which sounds like what your doctor is referring to.  What I had is called Trabeculoplasty.  That link has info on the different types of treatments.  It's been very successful for me.  It's an easy procedure as procedures go. 

The mapping of the retina sets a baseline so they can do comparisons going forward to see if your retina is thinning.  It's a good thing to have.  My retinas are both thin, with one having a lacy effect from a lifetime with progressive myopia.  That's where my acuity issues are:  myopic retinal degeneration!   My right eye is a mess!

Let us know how your diagnosis and treatment progresses.  Feel free to ask any questions.  We're here to help!

Bink/Barbara 

Thanks Barbara.

Both opthamologists asked if anybody in my family had glaucoma and I said no. Now I find out I do have a cousin that has had it for years. I'll have to mention that next month when I go back for the pressure check.

Sounds like you've had the majority of complications and seem to be adapting well. I hope to have your attitude if/when I get a definite diagnosis but as you said it's good it's caught early if the answer is yes, I do have glaucoma.

I keep thanking God the way things are happening. So many things have happened that are out of the norm that led to me insisting the doc check me for diabetes. His lack of concern and attitude that he was doing the test to appease me not because he wanted to led me to find another doctor. That doctor it turns out specializes in diabetes and will be starting a class in their office next month. He sent me to the opthamologist due to the diabetes which led to them finding the asymmetry and increased pressures. So, if it wasn't for 1 mess up with the original doc I wouldn't be where I am now which I guess is a blessing since things are being caught early.

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It's relatively easy to control, so try not to worry.  It's also a slow process and catching it early is the best thing that could happen.  

I had the same OD for 30 years, a friend of my first husband who is also an OD.  He knew my history; my mother and brother have glaucoma; he knew my pressures were high all the time and when I started to complain about the loss of vision back in the 90's he told me I had a cataract starting and let it go at that.  I was very angry when I first got the diagnosis from someone else and began legal inquiries.  Unfortunately, I would have had to proove how much vision had been lost within the two years previous, and I couldn't do that, so he got away with gross negligence.   

Then after I had the first surgery to implant the Aquaflow, I went totally blind in that eye on day three.  It turned out that my brain shut it off and it started to come back within a week or so.  It was very scary.  That's when I found this board and I was really happy to find people who understand what we go through with our vision issues. 

Feel free to whine, cry, celebrate and share whatever you like.  We're glad you are here.

Barbara

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