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Closed Tear Ducts/Ducts??

Question:

- Hide quoted text — Show quoted text -nrushing1…@hotmail.com (Nancy Rushing) wrote in message <news:4878071e.0402061726.2f0d5cda@posting.google.com>… > I was about 21 when I was diagnosed with high eye pressure, and > doctors have followed it for years until in 1999, when I started using > drops to lower the pressure (the highest at the time was 28).  Just > recently, I had a laser iridotomy in both eyes, since this new doctor > said he found that all the ducts in the quad (4) areas of both of my > eyes are all CLOSED!  The surgeries I had opened up the ducts which is > great….doctor said I had a great chance of having a "glaucoma > attack" from narrow angles (narrow angle glaucoma), and I would’ve > gone blind anytime, so it was an emergency to have the surgeries done > on my eyes. I am still using eye drops, but since the surgeries, my > pressure has lowered. Other eye doctors have mentioned have very > narrow tear ducts which wasn’t normal (before this doctor discovered > the problem — he’s a glaucoma specialist). >     I had a question about the closed tear ducts or ducts. Is this > congenital or can this happen anytime? I am 34 years old. >     Thanks to those who can answer my question.

The trabecular meshwork in the drainage angle in your eye has nothing to do with your tear ducts.  The eye has two plumbing systems, one inside and one outside.  The outer system involves the lacrimal gland, the gland that makes tears, and the lacrimal drainage system, the "tear ducts" that drain into your nose (that’s why we sniffle when we cry).  The internal plumbing system is what is involved frequently in glaucoma patients.  This involves the production of aqueous fluid by the ciliary glands behind the iris.  Fluid moves in through the pupil and drains where the iris meets the cornea in the front of the eye, in the "angle" that filters fluid through the trabecular meshwork.  In most folks, the angle is 30-40 degrees open, but if fluid can get TO the meshwork, it can’t get THROUGH it, and that raises eye pressure gradually.  That’s primary open angle glaucoma.      In a small percentage of people, the drain is less than 10 degrees open.  This is congenital and is often seen in people with very small eyes (farsighted individuals) with crowded tissues inside the front of the eye.  As these people get older and the lens in the eye becomes more of a cataract and thickens with time, the iris is further pushed forward and the angle closes off even more.  Where the iris touches the lens, a ball-valve effect is created which partially obstructs aqueous flow to the angle.  This may cause the iris to bulge forward and close off the angle permanently.  This can occur slowly (chronic angle closure) or quickly (acute angle closure), which is painful and can cause very rapid visual loss (over a day or two) if not corrected.  A laser iridotomy allows fluid to equilibrate on both sides of the iris and bypasses the pupil to allow aqueous a more direct access to the drain.  Even so, the drain itself may still not function perfectly even if an iridotomy is performed and the angle deepens (many call this "mixed-mechanism" glaucoma–it has aspects of both narrow and open angle glaucoma)…after an iridotomy, treatment is more or less the same, with topical drops to lower IOP.  Hope that answers some questions. –Rick Cohn, MD Glaucoma Specialist Winter Park, FL

Response:

I was about 21 when I was diagnosed with high eye pressure, and doctors have followed it for years until in 1999, when I started using drops to lower the pressure (the highest at the time was 28).  Just recently, I had a laser iridotomy in both eyes, since this new doctor said he found that all the ducts in the quad (4) areas of both of my eyes are all CLOSED!  The surgeries I had opened up the ducts which is great….doctor said I had a great chance of having a "glaucoma attack" from narrow angles (narrow angle glaucoma), and I would’ve gone blind anytime, so it was an emergency to have the surgeries done on my eyes. I am still using eye drops, but since the surgeries, my pressure has lowered. Other eye doctors have mentioned have very narrow tear ducts which wasn’t normal (before this doctor discovered the problem — he’s a glaucoma specialist).     I had a question about the closed tear ducts or ducts. Is this congenital or can this happen anytime? I am 34 years old.     Thanks to those who can answer my question.

Response:

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