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Pigmentary Dispersion Glaucoma

Question:

Jerry Griffin wrote: > I have had this for quite a while. Anyone else? Would like to hear about your > experiences.

I am 40 years old, and was diagnosed with pigmentary dispersion syndrome in my left eye two years ago by an optometrist during a routine eye exam.  I am very grateful to him.  I had been having "episodes" or "attacks" for the previous 12 years, and went to several optometrists and other doctors (not an opthomologist, though, since I had the impression that there was a waiting time of 6 months to see one).  The attacks almost always occurred toward the end of a day of prolonged physical activity.  During the attacks, I would experience a "greying out" of the visual field, often accompanied by scintillation or "seeing stars".  Less commonly I would see beautiful rainbows around lights. The symptoms always occurred in my left eye.  The medical diagnoses (before the pigment dispersion diagnosis) included "migraine". Therefore I didn’t worry too much about it.  After a night’s sleep my sight always returned to normal, anyway.  After learning of the pigment dispersion diagnosis, I did a lot of homework, including (recently) monitoring this news group.  I now realize that my "episodes" were in fact periods of massive pigment release which clogged up my trabecular meshwork and sent the eye pressure temporarily skyrocketing.  The symptoms were very reminiscent of when, as a kid, I used to press on my eyes with them closed to see the neat patterns that would result.  I now see the connection, so to speak.  The only time I had my pressure measured during an episode (a rather mild one as far as symptoms go) was last year, and the reading was 46 mm.  I had two laser treatments: an ALT (argon laser trabeculoplasty) and an iridotomy.  The trabeculoplasty had only temporary benefit, since it didn’t treat the SOURCE of the pigment release.  The iridotomy, which is intended to flatten the iris, MAY inhibit future pigment release.  I’m now in Pilocarpine and Betoptic drops and the pressure is holding at or below 20 mm.  At this point, I don’t have a lot of visual field loss, although there is significant cupping of the optic nerve at the retina.  I also have a trabecular meshwork that is chock full of pigment, so I will be a member of the glaucoma club for many years to come. One other symptom, which I have not reported as of yet, might be of interest to others with high intraocular pressure.  Before I went on eye drops (and now when I forget to take them) I experienced a large patch of color in the middle of my visual field which was most visible when I was in a completely dark room (such as in bed at night).  The colored patch would fade in and out, and continuously change hue, with a cycle time of something like 10 seconds.  As I have said, there appears to have been a correlation between this and my eye pressure. That’s a part of my experience so far with glaucoma.  In reference to a recent series of discussions in this news group, I was very upset, scared, and depressed when I learned that I had this condition and could potentially go blind (in my left eye at least).  What with taking my medication, getting my pressure and visual fields checked, and learning about the disease, it’s now a major part of my life.  I hope this is of help to you.

Response:

On Tue, 23 Dec 1997 00:10:04 -0500, Grif…@smartnet.net (Jerry Griffin) wrote: >I have had this for quite a while. Anyone else? Would like to hear about your >experiences. >JG

I’ve probably had it for many years but it was just diagnosed. When I was about 25 the Dr finally put me on eye drops after watching me for a long time. I did OK with them. As far as I know they called it open angle.. I had regular field tests done and they were maintaining. Suddenly whenI was maybe 36 my right eye got a lot worse. Then it stabalized and he field tests didn’t change much. I’m 42 now. A few years ago my glaucoma specialist started telling me that my right eye was worse after each field test (6 months apart). This kept up for about two years. I had the cold test where they put your hands in the ice water…  I flunked that big time. And I do have really cold hands…. One of the frustrating things is I could never get a good answer from him about "how much worse". It seemed that sometimes he wanted to scare me and other times he was telling me to not worry. I still really don’t know how serious my condition is. I asked if I was gonna lose my sight, he said no. I asked if I wouldn’t be able to drive and he also said no, that won’t happen either. Now I’m going to a different doctor, supposed to be the best of the bunch in the Tampa area.  He was the first to call it pigmentary dispersion glaucoma. My pressure stays in the 12-15 range. I take Xylatan, Alphagan, and Betagan. Tell me about your situation, I’d like to hear from someone else with this. earl

Response:

I have had this for quite a while. Anyone else? Would like to hear about your experiences. JG

Response:

On Tue, 23 Dec 1997 17:06:49 GMT, hst…@ix.netcom.com (Earl Scheib) wrote: >On Tue, 23 Dec 1997 00:10:04 -0500, Grif…@smartnet.net (Jerry >Griffin) wrote: >>I have had this for quite a while. Anyone else? Would like to hear about your >>experiences. >>JG >I’ve probably had it for many years but it was just diagnosed. When I >was about 25 the Dr finally put me on eye drops after watching me for >a long time. I did OK with them. As far as I know they called it open >angle..

A lot of glaucoma specialists are pretty sloppy.  As long as they can claim something is glaucoma, that’s good enough for them.  Different ones would call mine open-angle or angle-closure or both.  In my case, I don’t think it mattered.  In your case, of course, the distinction is very important to treatment, since the pressure never was all that high and there were no acute attacks. >I had regular field tests done and they were maintaining. Suddenly >whenI was maybe 36 my right eye got a lot worse. Then it stabalized >and he field tests didn’t change much. >I’m 42 now. A few years ago my glaucoma specialist started telling me >that my right eye was worse after each field test (6 months apart). >This kept up for about two years. >I had the cold test where they put your hands in the ice water…  I >flunked that big time. And I do have really cold hands….

What is the cold test? >One of the frustrating things is I could never get a good answer from >him about "how much worse".

Didn’t he even show you the charts from the field tests, so that you could compare them yourself? – Hide quoted text — Show quoted text ->It seemed that sometimes he wanted to >scare me and other times he was telling me to not worry. >I still really don’t know how serious my condition is. I asked if I >was gonna lose my sight, he said no. I asked if I wouldn’t be able to >drive and he also said no, that won’t happen either. >Now I’m going to a different doctor, supposed to be the best of the >bunch in the Tampa area.  He was the first to call it pigmentary >dispersion glaucoma. >My pressure stays in the 12-15 range. I take Xylatan, Alphagan, and >Betagan. >Tell me about your situation, I’d like to hear from someone else with >this.

As I recall, they can do something about shedding of pigment.  If that is causing the nerve damage, it may then stop progressing at some point, but maybe not right away.  I don’t have pigmentary glaucoma. Dr. Ritch, through Ray Bonar, will give you accurate info on that.  Of course, you want to be sure whether the *second* doc knows what he’s talking about.  Read Dr. Ritch’s FAQ.  Ray can give you the URL. Ray (not any sort of eye-care professional)

Response:

In article <34A0127B.1…@kodak.com>, Kim Eastman <c…@kodak.com> wrote: > I am 40 years old, and was diagnosed with pigmentary dispersion syndrome > in my left eye two years ago by an optometrist during a routine eye > exam.  . . .  I had been having "episodes" or > "attacks" for the previous 12 years

–snip—- > That’s a part of my experience so far with glaucoma.  In reference to a > recent series of discussions in this news group, I was very upset, > scared, and depressed when I learned that I had this condition and could > potentially go blind (in my left eye at least).  What with taking my > medication, getting my pressure and visual fields checked, and learning > about the disease, it’s now a major part of my life.  I hope this is of > help to you.

Thanks for sharing your experience. I have been monitored for the past ten years and, except for laser surgey before going overseas to live, have avoided drops due to the nature of PDS. At 51, newly diabetic, my pressures remain around 20 for both eyes. With good visdual fields and regular checkups I hope to keep things in check. thanks again, JG

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