opinions on eye problems sought from docs and patients

Question:

Hi Chris Re your questions: >Questions: >How frequently is an abnormality in the optic disk not caused by eye >disease seen in the population?

Very frequently, optic discs come in many shapes and sizes and most ‘abnormalities’ are not going to cause trouble however, by having it checked and reviewed, any changes should be found and if appropriate diagnosed. >Does this abnormality give strong evidence that she has glaucoma?

No >Is it possible to have intermittent increases in IOP that can damage the >eye?

Yes, particularly in the case of acute glaucoma (primary closed angle glaucoma) but the symptoms are considerable pain, hazy vision, halos around sources of light and if not transient, loss of vision. However, acute glaucoma is so painful that it causes little blindness except in rare cases of misdiagnosis or very bad luck. >I have found evidence of a linkage between benzodiazepines (mostly >diazepam) and glaucoma in medline. Does anyone have knowledge of what >effect these drugs have on eye pressure? Could 1-2 years of >benzodiazepine (clonazepam) use or its discontinuance cause temporary or >permenent glaucoma?

The use of certain antidepressant drugs would make the prescription of certain glaucoma medications unwise and this is the main link which you will have found in the literature. If there are specific examples you can give, we will give specific answers if you wish. >Could an episode of high pressure not be severely painful, but still >damaging?

The question of pain is usually associated with the rate of rise of pressure which is why chronic glaucoma (primary open angle glaucoma) can exhibit high pressures causing damage without giving warning symptoms whereas acute glaucoma is extremely painful. >Do people feel eye pressure at damaging levels as being an "ache" or >pressure or are these feelings more likely caused simply by tension?

In most cases people don’t feel the pressure except as above although aches are often associated by patients with pressure, in some cases rightly. >Is waiting a year and looking for changes in the optic disk appropriate >treatment? What else should we do? Should we seek a second opinion?

Its all a matter of trust – if you feel comfortable with the opinion of your ophthalmologist you are probably OK, if you are worried take a second opinion. In any case a second opinion can do no harm. >Should she be using pressure-lowering drugs or drops prophylactically?

If her pressures are normal and her visual field is OK then probably no. All medications have side effects and too lower a pressure can be as difficult as too higher a one. >Should she get more frequent pressure tests to see if her IOP is high >sometimes and not others?

As has been mentioned recently, pressure vary throughout the day and tend to be at their highest during the mid part, perhaps a test at this time would reassure you or you might request ‘phasing’ which is a repeated series of pressure tests to map these changes. >Should she have that visual field acuity test (the one that tests for >vision loss)?

You seem a little muddled by the terms here. Acuity is how sharply a person sees an object and the field is how widely they can see ie. the peripheral vision. If a field test was not carried out during the examination, it would be wise to have one done as it can help identify many other conditions apart from glaucoma. >How does one know what to do with ones life given the possibility of >blindness? Do you live for the moment and stop, say, going to school in >favor of doing things now that you may not be able to in the future?

From the story so far it would seem that blindness is not immediately on the horizon. Better to cross that bridge when you come to it. Life does go on even after blindness! – Hide quoted text — Show quoted text ->I have read many of the discussions in this group and there seem to be >many helpful people here. I would appreciate any help, information or >pointers to more information. Below are listed some references from >medline in case you happen to have that publication on your shelf. >Thank you. >- Chris Lukas

Response:

Writing as a layman with glaucoma: If she ever has another episode of discomfort in either eye she should _immediately_ consult an opthalmologist, or a hospital emergency room if no opthalmologist can see her within a few hours. I had an acute episode of elevated pressure in one eye and it cost me a permanent loss of some vision in that eye. Don’t fool around with this sort of thing. Even an hour matters.

Response:

Chris, I think it’s admirable that you’re seeking information on your wife’s condition, and there are some posting here who are qualified to offer pointers on glaucoma. But if I were in your wife’s position I’d go back to that ophthalmologist and lay a lot of these questions on him — that’s what you’re paying him for. (And I found many of your questions totally appropriate.) If you don’t get satisfactory answers, find a more communicative doctor. At 29 your wife should have many years of life ahead of her; she shouldn’t give her vision short shrift, in my opinion. And best of luck to her and you. Don Singleton – Hide quoted text — Show quoted text -chrislu…@lycosmail.com wrote: > Hello. I am seeking some more opinions and ideas about a possible case > of glaucoma or something else. Here’s the story: > . . . . > Thank you. > – Chris Lukas > references: > Bandych-Biniszkiewiczowa D. [Action of several neuroleptics and diazepam > on the hydrodynamics of the eye in healthy people and glaucoma > patients]. [Polish] Klinika Oczna. 85(7):269-71, 1983 Jul. > Bowden CL. Giffen MB. Psychotropics and glaucoma [letter]. American > Journal of Psychiatry. 134(11):1314, 1977 Nov. > Hyams SW. Keroub C. Glaucoma due to diazepam. American Journal of > Psychiatry. 134(4):447-8, 1977 Apr. > Malone DA Jr. Camara EG. Krug JH Jr. Ophthalmologic effects of > psychotropic medications. [Review] [30 refs] Psychosomatics. > 33(3):271-7, 1992 Summer. > Miller R. Benzodiazepines. [Review] [53 refs] Mount Sinai Journal of > Medicine. 50(4):289-94, 1983 Jul-Aug. > Edelen WB. Dangers of intravenously administered diazepam [letter]. > American Journal of Ophthalmology. 91(2):278-9, 1981 Feb. > Levine L. Reported ocular side effects of the ten most frequently > prescribed drugs. [Review] [33 refs] Journal of the American > Optometric Association. 50(2):221-7, 1979 Feb. > Barnes CD. Moolenaar GM. Effects of diazepam and picrotoxin on the > visual system. Neuropharmacology. 10(21):193-201, 1971 Mar. > –== Sent via Deja.com http://www.deja.com/ ==– > —Share what you know. Learn what you don’t.—

Response:

On Wed, 19 May 1999 16:52:16 +0000, Donald Singleton <donal…@sprynet.com> wrote: >Chris, > I think it’s admirable that you’re seeking information on your wife’s >condition, and there are some posting here who are qualified to offer >pointers on glaucoma. But if I were in your wife’s position I’d go back to >that ophthalmologist and lay a lot of these questions on him — that’s what >you’re paying him for.

Well, if he didn’t take any pains to explore more with you in the first place, he’s probably not the one you want to put a lot of effort into getting communication going with. Try a new one. Ray – Hide quoted text — Show quoted text -………

Response:

And one more thing: she should get a second opinion from an opthalmologist now, whatever else does or does not happen.

Response:

On Wed, 19 May 1999 12:51:24 -0400, "Mark Lape" <ml…@worldnet.att.net> wrote: > Chris, Hi. sorry about your wife’s troubles. I tried to answer some of >your questions below. I was told several months ago that the optic disc in >my right eye was shaped irregularly and that there was something causing >pressure on the optic nerve to cause this. Well not to worry you but the >common cause is a tumor. My ophthalmologist rushed me [and I do mean rushed >me ]out the door to the hospital to have a cat scan. Well that was something >I won’t forget. I won’t even get into how much fun I think a cat scan is >especially with a technician who doesn’t understand panic. Sorry to digress. >It turns out in my case to be nasal polyps causing the pressure.

That’s quite interesting. I find it almost impossible to ever get eye MDs to admit that nasal problems can ever cause eye problems. My main problem is nasal; however, it’s not polyps, and my eye problem was, unfortunately, glaucoma, which has taken out most of one eye, and, of course, what’s gone can’t be reversed by fixing anything in my nose. >since then >I have been on antibiotics and I’ve had several field vision tests which >have gotten better each time. I still have to decide what to do about the >polyps[surgery?] . If I were you I’d encourage your wife to get a second >opinion. Better safe than sorry. Let us know how things go. Hope this >helped.

Note that, if you don’t start you response, to part of a quote of the post you’re answering, on a *new line after* the last line of what your responding to, on many news clients, such as Free Agent, your first line will be blued out along with what you’re answering, and thus likely missed. You should break into what you’re answering and put blank lines before and after your response (and preferably replace any lost left-edge quote symbols in the first line of the next part of the post you’re responding to, after you insert. – Hide quoted text — Show quoted text -Linda<chrislu…@lycosmail.com> wrote in message >news:7hun8g$7hn$1@nnrp1.deja.com… >> Hello. I am seeking some more opinions and ideas about a possible case >> of glaucoma or something else. Here’s the story: >> 4 months ago, my wife, age 29, stopped taking (cold-turkey) an >> anti-anxiety drug called clonazepam (a benzodiazepine like valium, I >> believe). There were a number of withdrawal effects including tense >> muscles. One effect that we attributed to withdrawal was eye pain. It >> wasn’t severe eye pain, but my wife described it as a pressure inside >> or behind her eyes. This lasted approximately 2 weeks. >> Coincidentally, soon after this episode, she noticed a change in her >> distance vision. She had previously had near perfect vision, and it had >> become worse. It is possible that this had been the case for a while and >> she just noticed it, or it may have suddenly occurred. >> Another possible symptom of importance is that she tends to get what I >> would call eye strain after reading for several hours (4 or more). Her >> eyes ache and parts of the whites of her eyes are reddened. I can tell >> when she has been reading a lot because it shows in her eyes. At one >> point in the past, she got a prescription for reading glasses and this >> "eye strain" tends to occur more often when she doesn’t wear her old >> reading glasses (but occurs with them as well). >> She also has, at various points in the past, told me her eyes feel >> bulging or under pressure. Never before has she even thought or talked >> about glaucoma so I don’t think these descriptions are influenced by >> symptoms of the disease. >> Besides the distance blurriness, she has not noticed any other vision >> problems (dark spots, halos, etc.) >> Family history of glaucoma is unknown. >> Recently she went to the ophthalmologist and got a checkup. The results >> were sort of worrisome. She got a prescription for glasses >> (nearsightedness). She had normal eye pressure (don’t know the value). >> But the doctor noticed that something seemed odd about her optic disk in >> one eye. He didn’t say what it was, but that it had a different shape >> (?) than normal. He said it could be damage, or it could just be that >> way. >> The doctor then took measurements and photographs to, I assume, document >> the shape of the optic disk and told her to return in a year or so to >> check it again. >> I would really appreciate it if someone could comment on my questions >> below and give us some idea of how we should proceed. >> Questions: >> How frequently is an abnormality in the optic disk not caused by eye >> disease seen in the population? >> Does this abnormality give strong evidence that she has glaucoma?**** If >her eye pressure was normal than I’d assume she doesn’t have Glaucoma. >Glaucoma as I understand it is an increase in the pressure. My mom had it >for years and used prescription eye drops to keep the pressure down.

Well, glaucoma *isn’t* an increase in pressure; it’s weakened nerve and nerve-support tissues at the head of the optic nerve where it attaches to the retina. Considerable glaucoma occurs without intraocular pressure rising at all. Ray – Hide quoted text — Show quoted text -…..

Response:

Hi Chris, I think a second opinion sounds the way to go or return to the opthamologist with the list of questions that you have included in this post. A year is too long to wait. Last year My husband also had an eye problem. He had a routine eye test by an optometrist and was referred to an eye specialist as he had an indicator of macular degeneration. I spent 5 days stressing out as he waited for his appt with an eye specialists and far too much time on the Internet. After 1 and 1/2 hours of tests he had a diagnosis. He had the indicators but not the condition. He eyes are healthy. He just needs reading glasses (middle age). For your own piece of mind find a specialist who can address your concerns. Good luck, Meryl <chrislu…@lycosmail.com> wrote in message

news:7hun8g$7hn$1@nnrp1.deja.com… – Hide quoted text — Show quoted text -> Hello. I am seeking some more opinions and ideas about a possible case > of glaucoma or something else. Here’s the story: > 4 months ago, my wife, age 29, stopped taking (cold-turkey) an > anti-anxiety drug called clonazepam (a benzodiazepine like valium, I > believe). There were a number of withdrawal effects including tense > muscles. One effect that we attributed to withdrawal was eye pain. It > wasn’t severe eye pain, but my wife described it as a pressure inside > or behind her eyes. This lasted approximately 2 weeks. > Coincidentally, soon after this episode, she noticed a change in her > distance vision. She had previously had near perfect vision, and it had > become worse. It is possible that this had been the case for a while and > she just noticed it, or it may have suddenly occurred. > Another possible symptom of importance is that she tends to get what I > would call eye strain after reading for several hours (4 or more). Her > eyes ache and parts of the whites of her eyes are reddened. I can tell > when she has been reading a lot because it shows in her eyes. At one > point in the past, she got a prescription for reading glasses and this > "eye strain" tends to occur more often when she doesn’t wear her old > reading glasses (but occurs with them as well). > She also has, at various points in the past, told me her eyes feel > bulging or under pressure. Never before has she even thought or talked > about glaucoma so I don’t think these descriptions are influenced by > symptoms of the disease. > Besides the distance blurriness, she has not noticed any other vision > problems (dark spots, halos, etc.) > Family history of glaucoma is unknown. > Recently she went to the ophthalmologist and got a checkup. The results > were sort of worrisome. She got a prescription for glasses > (nearsightedness). She had normal eye pressure (don’t know the value). > But the doctor noticed that something seemed odd about her optic disk in > one eye. He didn’t say what it was, but that it had a different shape > (?) than normal. He said it could be damage, or it could just be that > way. > The doctor then took measurements and photographs to, I assume, document > the shape of the optic disk and told her to return in a year or so to > check it again. > I would really appreciate it if someone could comment on my questions > below and give us some idea of how we should proceed. > Questions: > How frequently is an abnormality in the optic disk not caused by eye > disease seen in the population? > Does this abnormality give strong evidence that she has glaucoma? > Is it possible to have intermittent increases in IOP that can damage the > eye? > I have found evidence of a linkage between benzodiazepines (mostly > diazepam) and glaucoma in medline. Does anyone have knowledge of what > effect these drugs have on eye pressure? Could 1-2 years of > benzodiazepine (clonazepam) use or its discontinuance cause temporary or > permenent glaucoma? > Could an episode of high pressure not be severely painful, but still > damaging? > Do people feel eye pressure at damaging levels as being an "ache" or > pressure or are these feelings more likely caused simply by tension? > Is waiting a year and looking for changes in the optic disk appropriate > treatment? What else should we do? Should we seek a second opinion? > Should she be using pressure-lowering drugs or drops prophylactically? > Should she get more frequent pressure tests to see if her IOP is high > sometimes and not others? > Should she have that visual field acuity test (the one that tests for > vision loss)? > How does one know what to do with ones life given the possibility of > blindness? Do you live for the moment and stop, say, going to school in > favor of doing things now that you may not be able to in the future? > I have read many of the discussions in this group and there seem to be > many helpful people here. I would appreciate any help, information or > pointers to more information. Below are listed some references from > medline in case you happen to have that publication on your shelf. > Thank you. > – Chris Lukas > references: > Bandych-Biniszkiewiczowa D. [Action of several neuroleptics and diazepam > on the hydrodynamics of the eye in healthy people and glaucoma > patients]. [Polish] Klinika Oczna. 85(7):269-71, 1983 Jul. > Bowden CL. Giffen MB. Psychotropics and glaucoma [letter]. American > Journal of Psychiatry. 134(11):1314, 1977 Nov. > Hyams SW. Keroub C. Glaucoma due to diazepam. American Journal of > Psychiatry. 134(4):447-8, 1977 Apr. > Malone DA Jr. Camara EG. Krug JH Jr. Ophthalmologic effects of > psychotropic medications. [Review] [30 refs] Psychosomatics. > 33(3):271-7, 1992 Summer. > Miller R. Benzodiazepines. [Review] [53 refs] Mount Sinai Journal of > Medicine. 50(4):289-94, 1983 Jul-Aug. > Edelen WB. Dangers of intravenously administered diazepam [letter]. > American Journal of Ophthalmology. 91(2):278-9, 1981 Feb. > Levine L. Reported ocular side effects of the ten most frequently > prescribed drugs. [Review] [33 refs] Journal of the American > Optometric Association. 50(2):221-7, 1979 Feb. > Barnes CD. Moolenaar GM. Effects of diazepam and picrotoxin on the > visual system. Neuropharmacology. 10(21):193-201, 1971 Mar. > –== Sent via Deja.com http://www.deja.com/ ==– > —Share what you know. Learn what you don’t.—

Response:

Chris, Hi. sorry about your wife’s troubles. I tried to answer some of your questions below. I was told several months ago that the optic disc in my right eye was shaped irregularly and that there was something causing pressure on the optic nerve to cause this. Well not to worry you but the common cause is a tumor. My ophthalmologist rushed me [and I do mean rushed me ]out the door to the hospital to have a cat scan. Well that was something I won’t forget. I won’t even get into how much fun I think a cat scan is especially with a technician who doesn’t understand panic. Sorry to digress. It turns out in my case to be nasal polyps causing the pressure. since then I have been on antibiotics and I’ve had several field vision tests which have gotten better each time. I still have to decide what to do about the polyps[surgery?] . If I were you I’d encourage your wife to get a second opinion. Better safe than sorry. Let us know how things go. Hope this helped. Linda<chrislu…@lycosmail.com> wrote in message

her eye pressure was normal than I’d assume she doesn’t have Glaucoma. Glaucoma as I understand it is an increase in the pressure. My mom had it for years and used prescription eye drops to keep the pressure down. – Hide quoted text — Show quoted text -> Is it possible to have intermittent increases in IOP that can damage the > eye? > I have found evidence of a linkage between benzodiazepines (mostly > diazepam) and glaucoma in medline. Does anyone have knowledge of what > effect these drugs have on eye pressure? Could 1-2 years of > benzodiazepine (clonazepam) use or its discontinuance cause temporary or > permenent glaucoma? > Could an episode of high pressure not be severely painful, but still > damaging? Usually people with Glaucoma don’t know they have it–no symptoms initially. > Do people feel eye pressure at damaging levels as being an "ache" or > pressure or are these feelings more likely caused simply by tension? > Is waiting a year and looking for changes in the optic disk appropriate > treatment? What else should we do? Should we seek a second opinion? I’d

seek another opinion. – Hide quoted text — Show quoted text -> Should she be using pressure-lowering drugs or drops prophylactically? > Should she get more frequent pressure tests to see if her IOP is high > sometimes and not others? > Should she have that visual field acuity test (the one that tests for > vision loss)? > How does one know what to do with ones life given the possibility of > blindness? Do you live for the moment and stop, say, going to school in > favor of doing things now that you may not be able to in the future? > I have read many of the discussions in this group and there seem to be > many helpful people here. I would appreciate any help, information or > pointers to more information. Below are listed some references from > medline in case you happen to have that publication on your shelf. > Thank you. > – Chris Lukas > references: > Bandych-Biniszkiewiczowa D. [Action of several neuroleptics and diazepam > on the hydrodynamics of the eye in healthy people and glaucoma > patients]. [Polish] Klinika Oczna. 85(7):269-71, 1983 Jul. > Bowden CL. Giffen MB. Psychotropics and glaucoma [letter]. American > Journal of Psychiatry. 134(11):1314, 1977 Nov. > Hyams SW. Keroub C. Glaucoma due to diazepam. American Journal of > Psychiatry. 134(4):447-8, 1977 Apr. > Malone DA Jr. Camara EG. Krug JH Jr. Ophthalmologic effects of > psychotropic medications. [Review] [30 refs] Psychosomatics. > 33(3):271-7, 1992 Summer. > Miller R. Benzodiazepines. [Review] [53 refs] Mount Sinai Journal of > Medicine. 50(4):289-94, 1983 Jul-Aug. > Edelen WB. Dangers of intravenously administered diazepam [letter]. > American Journal of Ophthalmology. 91(2):278-9, 1981 Feb. > Levine L. Reported ocular side effects of the ten most frequently > prescribed drugs. [Review] [33 refs] Journal of the American > Optometric Association. 50(2):221-7, 1979 Feb. > Barnes CD. Moolenaar GM. Effects of diazepam and picrotoxin on the > visual system. Neuropharmacology. 10(21):193-201, 1971 Mar. > –== Sent via Deja.com http://www.deja.com/ ==– > —Share what you know. Learn what you don’t.—

Response:

Hello. I am seeking some more opinions and ideas about a possible case of glaucoma or something else. Here’s the story: 4 months ago, my wife, age 29, stopped taking (cold-turkey) an anti-anxiety drug called clonazepam (a benzodiazepine like valium, I believe). There were a number of withdrawal effects including tense muscles. One effect that we attributed to withdrawal was eye pain. It wasn’t severe eye pain, but my wife described it as a pressure inside or behind her eyes. This lasted approximately 2 weeks. Coincidentally, soon after this episode, she noticed a change in her distance vision. She had previously had near perfect vision, and it had become worse. It is possible that this had been the case for a while and she just noticed it, or it may have suddenly occurred. Another possible symptom of importance is that she tends to get what I would call eye strain after reading for several hours (4 or more). Her eyes ache and parts of the whites of her eyes are reddened. I can tell when she has been reading a lot because it shows in her eyes. At one point in the past, she got a prescription for reading glasses and this "eye strain" tends to occur more often when she doesn’t wear her old reading glasses (but occurs with them as well). She also has, at various points in the past, told me her eyes feel bulging or under pressure. Never before has she even thought or talked about glaucoma so I don’t think these descriptions are influenced by symptoms of the disease. Besides the distance blurriness, she has not noticed any other vision problems (dark spots, halos, etc.) Family history of glaucoma is unknown. Recently she went to the ophthalmologist and got a checkup. The results were sort of worrisome. She got a prescription for glasses (nearsightedness). She had normal eye pressure (don’t know the value). But the doctor noticed that something seemed odd about her optic disk in one eye. He didn’t say what it was, but that it had a different shape (?) than normal. He said it could be damage, or it could just be that way. The doctor then took measurements and photographs to, I assume, document the shape of the optic disk and told her to return in a year or so to check it again. I would really appreciate it if someone could comment on my questions below and give us some idea of how we should proceed. Questions: How frequently is an abnormality in the optic disk not caused by eye disease seen in the population? Does this abnormality give strong evidence that she has glaucoma? Is it possible to have intermittent increases in IOP that can damage the eye? I have found evidence of a linkage between benzodiazepines (mostly diazepam) and glaucoma in medline. Does anyone have knowledge of what effect these drugs have on eye pressure? Could 1-2 years of benzodiazepine (clonazepam) use or its discontinuance cause temporary or permenent glaucoma? Could an episode of high pressure not be severely painful, but still damaging? Do people feel eye pressure at damaging levels as being an "ache" or pressure or are these feelings more likely caused simply by tension? Is waiting a year and looking for changes in the optic disk appropriate treatment? What else should we do? Should we seek a second opinion? Should she be using pressure-lowering drugs or drops prophylactically? Should she get more frequent pressure tests to see if her IOP is high sometimes and not others? Should she have that visual field acuity test (the one that tests for vision loss)? How does one know what to do with ones life given the possibility of blindness? Do you live for the moment and stop, say, going to school in favor of doing things now that you may not be able to in the future? I have read many of the discussions in this group and there seem to be many helpful people here. I would appreciate any help, information or pointers to more information. Below are listed some references from medline in case you happen to have that publication on your shelf. Thank you. – Chris Lukas references: Bandych-Biniszkiewiczowa D. [Action of several neuroleptics and diazepam on the hydrodynamics of the eye in healthy people and glaucoma patients]. [Polish] Klinika Oczna. 85(7):269-71, 1983 Jul. Bowden CL. Giffen MB. Psychotropics and glaucoma [letter]. American Journal of Psychiatry. 134(11):1314, 1977 Nov. Hyams SW. Keroub C. Glaucoma due to diazepam. American Journal of Psychiatry. 134(4):447-8, 1977 Apr. Malone DA Jr. Camara EG. Krug JH Jr. Ophthalmologic effects of psychotropic medications. [Review] [30 refs] Psychosomatics. 33(3):271-7, 1992 Summer. Miller R. Benzodiazepines. [Review] [53 refs] Mount Sinai Journal of Medicine. 50(4):289-94, 1983 Jul-Aug. Edelen WB. Dangers of intravenously administered diazepam [letter]. American Journal of Ophthalmology. 91(2):278-9, 1981 Feb. Levine L. Reported ocular side effects of the ten most frequently prescribed drugs. [Review] [33 refs] Journal of the American Optometric Association. 50(2):221-7, 1979 Feb. Barnes CD. Moolenaar GM. Effects of diazepam and picrotoxin on the visual system. Neuropharmacology. 10(21):193-201, 1971 Mar. –== Sent via Deja.com http://www.deja.com/ ==– —Share what you know. Learn what you don’t.—

Glaucoma Disease

Information about Glaucoma

Acute Glaucoma

opinions on eye problems sought from docs and patients

Question:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Related Posts

Write a comment