Heifer…@gmail.com wrote: > Yeah, that’s the IT of it. > My parents had me seen by the Glaucoma Associates of New York and they > knew exactly what to do with me, so that’s where I’ll be having my > surgery. The Indiana docs put me on Diamox a couple weeks ago because I > was having black outs and SEVERE behind-the-eye pain. The Diamox is > helping, but my pressure is still way too high. The doctors in NY said > that the Uveitis messed up the meshwork on a cellular level so they’re > going to have to look at it more closely when I get out there (I > think).

I’m glad you are seeing a doctor you are happier with. I presume they have some Uveitis specialists too. The Uveitis will trash the Trabecular Meswork – that’s why sorting the Uveitis has to be job no 1. What treatment are you on for the Uveitis and the Glaucoma? Did they discuss any dietary or lifestyle changes as well? Good Luck!

Response:

Seems I’ve read in the Saturday Evening Post that there’s a renowned eye clinic at the University of Indiana in Indianapolis.  You might check that out. I don’t know anything about your particular condition.  But I do know steroid eye drops like Pred Forte can raise pressure.  Nevertheless, even glaucoma specialists will require its use for several weeks after eye surgery.  It’s necessary to prevent inflammation and scarring, which could negate the results of the surgery. Laura On 24 Aug 2005 22:32:37 -0700, "Heifer…@gmail.com" – Hide quoted text — Show quoted text -<Heifer…@gmail.com> wrote: >I’m new here. Hey! I’m 20 from Indiana and last year I was roundaboutly >diagnosed with Pars Plantis in only my left eye. I say roundaboutly >because it started in March 04 , I took all the blood tests and x-rays >and nothing was found, but I still never had anyone actually tell me >what it was that was wrong with me until I saw a specialist in CT in >December 04. They put me on Pred-Forte to chill my retina out (which >thankfully helped). Anyway, in July 04 the people here in IN gave me a >Kenalog injection and it’s now August 05 and the deposit of meds is >still in my eye. My Pars Plantis went away, but now I’m stuck with >open-angle glaucoma and a cataract. I’ve been on Alphagan since last >October (I think), Cosopt since May, and Travatan for about a month. My >pressure is still 40 and won’t budge at all. In about two weeks I’m >going to see a specialist in New York because my parents don’t trust >the jerks here in IN. >Erm, I guess what I’m going for here is just people to talk to. I’ve >been told I will have to have surgery on my eye for the glaucoma if it >doesn’t lose the pressure. Damage has already been done to my retina. >Alphagan 3X, Cosopt 2X and Travatan 1X a day and I’m still getting eye >pain and headaches sometimes at night like I’m not taking anything at >all. >Has anyone else had the steroid-induced stuff happen to them? Are your >doctors more worried? My doctors seem to be dragging their feet like >they don’t care… hence my going to NY. Anyone else have a similar >situation??

Response:

I haven’t heard anything about the University of Indiana clinic, which is strange. I also didn’t know that after surgery it’s used. That’s a good and interesting thing to know. It makes sense though.

Response:

- Hide quoted text — Show quoted text -Heifer…@gmail.com wrote: > I’m new here. Hey! I’m 20 from Indiana and last year I was roundaboutly > diagnosed with Pars Plantis in only my left eye. I say roundaboutly > because it started in March 04 , I took all the blood tests and x-rays > and nothing was found, but I still never had anyone actually tell me > what it was that was wrong with me until I saw a specialist in CT in > December 04. They put me on Pred-Forte to chill my retina out (which > thankfully helped). Anyway, in July 04 the people here in IN gave me a > Kenalog injection and it’s now August 05 and the deposit of meds is > still in my eye. My Pars Plantis went away, but now I’m stuck with > open-angle glaucoma and a cataract. I’ve been on Alphagan since last > October (I think), Cosopt since May, and Travatan for about a month. My > pressure is still 40 and won’t budge at all. In about two weeks I’m > going to see a specialist in New York because my parents don’t trust > the jerks here in IN. > Erm, I guess what I’m going for here is just people to talk to. I’ve > been told I will have to have surgery on my eye for the glaucoma if it > doesn’t lose the pressure. Damage has already been done to my retina. > Alphagan 3X, Cosopt 2X and Travatan 1X a day and I’m still getting eye > pain and headaches sometimes at night like I’m not taking anything at > all. > Has anyone else had the steroid-induced stuff happen to them? Are your > doctors more worried? My doctors seem to be dragging their feet like > they don’t care… hence my going to NY. Anyone else have a similar > situation??

This is familiar. I started with Uveitis in my teens and had glaucoma and cataracts. Uveitis is imflammation of the Uveal tract which can affect the Trabecular Mesh (the eyes drainage network) and in turn lead to Glaucoma. Steroidal anti imflammatories are normally used to treat the Uveitis but they can also cause raised IOP and can also promote the growth of a cataract. (There are also non-steroidal anti imflammatories but these have their problems too and are not as effective). So the Uveitis and the treatment for Uveitis can cause glaucoma therefore they need to treat that as a secondary condition. I was given tablets to reduce the pressure (Diamox sustained release) which was effective but led to potassium depletion (eat a banana). The secondary Glaucoma is serious, it can cause permanent optic nerve damage and affect your visual fields – sufficient damage will mean no driving. Once the Uveitis is under control and you are off steroids they can continue to treat any remaining glaucoma which will hopefully be lesser and respond OK for you. Once you have had uveitis there is always a risk of post operative implammation flaring it up again so they will be more careful with you if you ever have surgery. ianad.

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I just had a trabulectomy last Tuesday. The pressure was up to 46. Currently, they have me on Pred-Forte and oral steroids to block any and all inflamation possible while my eye heals. Yeah, these guys in NYC are fantastic. Dr. Samson, the Uveitis guy, is just amazing. He put everything together for me and my parents. As for dietary or lifestyle changes, no. No one has spoken to me about that. I’d like to think that I’m a fairly healthy person… lol. And right after they let me, I’ll go back to exercising properly.

Response:

Yeah, that’s the IT of it. My parents had me seen by the Glaucoma Associates of New York and they knew exactly what to do with me, so that’s where I’ll be having my surgery. The Indiana docs put me on Diamox a couple weeks ago because I was having black outs and SEVERE behind-the-eye pain. The Diamox is helping, but my pressure is still way too high. The doctors in NY said that the Uveitis messed up the meshwork on a cellular level so they’re going to have to look at it more closely when I get out there (I think).

Response:

Heifer…@gmail.com wrote: > I haven’t heard anything about the University of Indiana clinic, which > is strange. > I also didn’t know that after surgery it’s used. That’s a good and > interesting thing to know. It makes sense though.

I can highly recommend The Midwest Eye Institute, http://www.midwesteye.com/home.htm. Dr. Valerie Purvin diagnosed and cured my Giant Cell Arteritis with zero vision loss. Dave in Northern Indiana

Response:

I’m new here. Hey! I’m 20 from Indiana and last year I was roundaboutly diagnosed with Pars Plantis in only my left eye. I say roundaboutly because it started in March 04 , I took all the blood tests and x-rays and nothing was found, but I still never had anyone actually tell me what it was that was wrong with me until I saw a specialist in CT in December 04. They put me on Pred-Forte to chill my retina out (which thankfully helped). Anyway, in July 04 the people here in IN gave me a Kenalog injection and it’s now August 05 and the deposit of meds is still in my eye. My Pars Plantis went away, but now I’m stuck with open-angle glaucoma and a cataract. I’ve been on Alphagan since last October (I think), Cosopt since May, and Travatan for about a month. My pressure is still 40 and won’t budge at all. In about two weeks I’m going to see a specialist in New York because my parents don’t trust the jerks here in IN. Erm, I guess what I’m going for here is just people to talk to. I’ve been told I will have to have surgery on my eye for the glaucoma if it doesn’t lose the pressure. Damage has already been done to my retina. Alphagan 3X, Cosopt 2X and Travatan 1X a day and I’m still getting eye pain and headaches sometimes at night like I’m not taking anything at all. Has anyone else had the steroid-induced stuff happen to them? Are your doctors more worried? My doctors seem to be dragging their feet like they don’t care… hence my going to NY. Anyone else have a similar situation??

Response:

Great Post, Sherry!  All I would add is that if your friend has had a 50% drop in eye pressure with these meds and currently hovers in the low to mid teens, that is likely to be sufficient to prevent any significant futher loss of vision.  If he can get the drops, as Sherry said, as samples from the doc or from the drug companies (all of them have programs to provide free or reduced cost meds to the poor) and actually uses them, hopefully he won’t show progressive loss on his visual field tests.  I would only recommend a trab if definitive progression is present on the fields.  As for the "world class medical centers," they are often not worth half the hype they get.  The patients are often worked-up (and sometimes worked over) by residents and fellows…then the big name attending physician spends five minutes with you.  Many of these, known for publishing a ton of papers and teaching at medical meetings, have absolutely no bedside manner.  When you go to them for surgery, it is done by the fellow with the attending sitting right by his/her side (and the patient can’t tell the difference).  I might get an opinion from a university-based specialist, but I wouldn’t want to hang out there for good. –Rick Cohn, MD Glaucoma Specialist Winter Park, FL

Response:

On 12 Aug 2005 19:36:59 -0700, eyegu…@aol.com wrote: >As for the "world class medical >centers," they are often not worth half the hype they get.  The >patients are often worked-up (and sometimes worked over) by residents >and fellows…then the big name attending physician spends five minutes >with you.  Many of these, known for publishing a ton of papers and >teaching at medical meetings, have absolutely no bedside manner.  When >you go to them for surgery, it is done by the fellow with the attending >sitting right by his/her side (and the patient can’t tell the >difference).  I might get an opinion from a university-based >specialist, but I wouldn’t want to hang out there for good. >–Rick Cohn, MD >Glaucoma Specialist >Winter Park, FL

That certainly is "telling it like it is," Dr. Cohn — Thanks! But we must remember that the supply of private-practice surgeons is dependent on University teaching "medical centers."  All experienced surgeons were once "residents," and they won’t live forever. On the issue of "frequently publishing physicians" (Having participated in that game in a different field, I recognize the implications ):  One of my eyes was badly damaged in uncomplicated cataract surgery by a [non-University] surprisingly-young FACS with a slew of publications.  I got the impression that he sometimes used self-invented new techniques. One of them backfired on me. John

Response:

I’m posting this for a friend.  He’s a very talented artist, and has been told that he may well soon go blind from advanced glaucoma.  He’s now 55 years old.  He was first diagnosed with glaucoma in his mid-20’s but did nothing about it until his mid-40’s, when he first began to notice vision loss.  He’s seen an ophthalmologist since 1999, who, upon her initial examination, proclaimed that he had severe optic nerve damage, and advanced glaucoma.  The pressure at that time, in each eye, was over 30.  Through the continued use of alphagan p, cosopt and xalatan, the pressure has dropped substantially and now ordinarily hovers between 10 and 15. His doctor mentioned the possibility of surgery (a trabeculectomy), but this was prior to the stabilization of the pressure, with which she seemed relatively pleased.  She suggested that although surgery could bring the pressure down even further and could last several years before another surgery would be necessary, it would definitely cause even further vision loss.  He recently saw another MD, who looked over his records, did a pressure check, surveyed the optic nerves, and told him that his glaucoma was now in the end stage.  On the other hand, he can still see well enough (at least in one eye) to paint. He’s only seen two doctors for his condition, and I don’t believe either were at world class medical centers.  (He’s in the LA basin area.)  Any recommendations as to possible new treatments, clinical trials, evaluations he should have, etc.?  Any suggestions would be greatly appreciated! P.S.  In addition to waiting far too long to seek treatment (partly driven by financial considerations and no health insurance), he also engages in a number of likely lifestyle no-nos for glaucoma patients. He smokes a pack of cigarettes a day, and drinks 2-3 cups of coffee a day.  Also, about three times a month, he parties, and drinks a six pack of beer at a setting.

Response:

> A trab can cause a small amount of loss of visual acuity, which would > be better than going blind from *not* having a trab.  It’s usually > just a line or so on the Snellen Chart – if he’s seeing 20/20, he > might drop to 20/25 or 20/30.  No big deal.  I see 20/40 after my > trabs and my pressures are holding at 10 without drops.

My experience was the exact opposite.  After having cataract and trab surgery I now see 20/25 in both eyes.  With glasses or contacts I never corrected better than 20/30 in one eye and 20/40 in the other eye.  My pressures have been running about 12 and 15 without drops. Don

Response:

mel…@sbcglobal.net wrote in news:1123685857.876592.216080@g49g2000cwa.googlegroups.com: – Hide quoted text — Show quoted text -> I’m posting this for a friend.  He’s a very talented artist, and has > been told that he may well soon go blind from advanced glaucoma. > He’s now 55 years old.  He was first diagnosed with glaucoma in his > mid-20’s but did nothing about it until his mid-40’s, when he first > began to notice vision loss. <snip> > His doctor mentioned the possibility of surgery (a trabeculectomy), > but this was prior to the stabilization of the pressure, with which > she seemed relatively pleased.  She suggested that although surgery > could bring the pressure down even further and could last several > years before another surgery would be necessary, it would definitely > cause even further vision loss.<snip> > He’s only seen two doctors for his condition, and I don’t believe > either were at world class medical centers.  (He’s in the LA basin > area.)  Any recommendations as to possible new treatments, clinical > trials, evaluations he should have, etc.?  Any suggestions would be > greatly appreciated! > P.S.  In addition to waiting far too long to seek treatment (partly > driven by financial considerations and no health insurance), he also > engages in a number of likely lifestyle no-nos for glaucoma > patients. He smokes a pack of cigarettes a day, and drinks 2-3 cups > of coffee a day.  Also, about three times a month, he parties, and > drinks a six pack of beer at a setting.

Oh dear….well, he’s certainly a poster boy for what not to do if you are diagnosed with glaucoma!  Chances are had he paid attention to his doc in the beginning, he’d still be seeing fairly well.  He’s lucky to be in the LA area.  There are two excellent medical schools with great eye clinics – He could go to UC Irvine Doheny Eye Clinic or UCLA Jules Stein Eye Clinic – I’m sure they have accomodations for charity care. A list of glaucoma specialists at those two universities and others (Dr. Weinreb at Shiley Eye Center in La Jolla would also be an excellent choice) can be found at http://www.glaucomaweb.org/patients/find.htm?state=CA Any reason he’s not on MediCal? Also, for meds, a lot of patients will get samples from their glauc docs and never have to buy drops.  Drug companies are offering free meds – try http://www.needymeds.com for more info on that. A trab can cause a small amount of loss of visual acuity, which would be better than going blind from *not* having a trab.  It’s usually just a line or so on the Snellen Chart – if he’s seeing 20/20, he might drop to 20/25 or 20/30.  No big deal.  I see 20/40 after my trabs and my pressures are holding at 10 without drops. There are a lot of visual artists who are blind, so it’s not hopeless that he’ll not be able to continue his art.  Do a google search on "blind visual artists" for a lot of interesting articles. Good luck! Sherry

Response:

Also is there any proven methoed to cut down on the floaters I am seeing , I was told there isn’t anything to be done about it but figured I would ask here.. "Anthony" <optim…@optonline.net> wrote in message

news:50KDe.239$mf5.142@fe12.lga… – Hide quoted text — Show quoted text -> The person who is doing the eye exams isnt even a opthmologist its an > optomitrist ..when i went to him I had no clue I had any problems. I just > went because my union sent me to him to see if I needed glasses , but he > has all the machines to do the full testing for Glaucoma..I think no > matter what happens today I need to go to get a 2nd opinion. You said this > below > I used Xalatan for 5 years > before I had trabeculectomies > What is trabeculectomies , some kind of surgery? Is Xalatan relatively > safe? Thanks a lot for your reply. > "Sherry" <she…@excite.com> wrote in message > news:Xns96998A92DFD98TansyRagwortNetscape@216.196.97.142… >> "Anthony" <optim…@optonline.net> wrote in >> news:LNUCe.150047$mx5.73941@fe08.lga: >>> I may have glaucoma , I will know more on Thursday..the cups in both >>> eyes are enlarged and the pressure in both eyes is high although I >>> don’t know the exact number of my IOP. Anyway I passed the >>> peripheral vision test and i took a test for blood flow to the eyes >>> and the doctor said that it was fine as well..On thursday I get more >>> of the pressure tests , a cornea thickness test and a laser 3D pic >>> of my eye ( the last pic he took to see the cup was a big polaroid >>> machine pic )..the problems I have been having though I don’t >>> believe are related to my eye problems..he also said i was far >>> sighted and near sighted and needed reading glasses which he gave >>> me..the reason i went there is i felt a strange pain in my left side >>> of my forehead..the next day my left eye was blurry and had a lot of >>> floaters and my head felt like it was under enormous pressure…all >>> around my temples and top of my head..I also had an MRI which was >>> negative..can glaucoma give you a lot of head pressure/pain and if i >>> do have glaucoma what is the best medicine (eyedrops i guess)  i can >>> take for it , i dont want to screw with my heart at all as I have >>> pac’s and high cholesterol and slightly high blood pressure.I am >>> also seeing an ENT on Friday because I did have a long time cocaine >>> problem that i kicked at the beginning of the year and i am >>> wondering if that has something to do with my head issues. Thx for >>> any advice and sorry this was so long. >> Anthony, >> I’m not a doc, just a fairly-well educated glaucoma patient.  Glaucoma >> is diagnosed by damage to the optic nerve.  Elevated pressure is only >> one of the glaucoma risks (there are people who have elevated pressures >> and never develop glaucoma and there are people who have normal >> pressures with glaucoma!)  It looks like you’re getting a really >> thorough exam.  That’s great!  So many people get an elevated pressure >> and the eye docs says "you’ve got glaucoma. Here are drops.  Go home >> and use them!" >> Glaucoma can can pain if you have acute angle closure or really super >> high pressures, but it’s eye pain, not a headache as normally >> experienced.  BTW, migraines can also be a risk factor for glaucoma! >> I’m glad the MRI was negative. >> If and when your glaucoma specialist (you are seeing one, right?) >> prescribes drops, he’ll be the one to determine which ones would be >> best for you. I know with me it was trial and error to find the ones >> that worked for me and didn’t have insufferable adverse reactions. >> Many glaucoma patients get a great drop in IOP with beta blocker drops >> – I couldn’t tolerate them (I got migraines!).  There is a new class >> called prostaglandin analogues – Xalatan, Lumigan and Travatan – all >> which work very well for most people.  I used Xalatan for 5 years >> before I had trabeculectomies.  (It was the 6th drug my eye doc tried >> on me – the others either gave me serious side effects, allergic >> reactions or just weren’t effective!  But not everyone has this >> problem, so don’t despair!) >> If and when you do get drops prescribed, be sure to use them faithfully >> and to use good punctal occlusion techniques to keep the meds from >> going down the tear ducts and getting absorbed into your system (well, >> a bit will be absorbed, but this will minimize the amount).  There’s a >> good video at http://www.nyee.edu/video.html "How to Put Drops in Your >> Eyes: The Ritch-Sussman Technique" which shows you how. >> Good luck and keep us posted! >> Sherry

Response:

Damn it figures the group is dead when I arrive , its my bad luck continuing "Anthony" <optim…@optonline.net> wrote in message

news:LNUCe.150047$mx5.73941@fe08.lga… – Hide quoted text — Show quoted text ->I may have glaucoma , I will know more on Thursday..the cups in both eyes >are enlarged and the pressure in both eyes is high although I don’t know >the exact number of my IOP. Anyway I passed the peripheral vision test and >i took a test for blood flow to the eyes and the doctor said that it was >fine as well..On thursday I get more of the pressure tests , a cornea >thickness test and a laser 3D pic of my eye ( the last pic he took to see >the cup was a big polaroid machine pic )..the problems I have been having >though I don’t believe are related to my eye problems..he also said i was >far sighted and near sighted and needed reading glasses which he gave >me..the reason i went there is i felt a strange pain in my left side of my >forehead..the next day my left eye was blurry and had a lot of floaters and >my head felt like it was under enormous pressure…all around my temples >and top of my head..I also had an MRI which was negative..can glaucoma give >you a lot of head pressure/pain and if i do have glaucoma what is the best >medicine (eyedrops i guess)  i can take for it , i dont want to screw with >my heart at all as I have pac’s and high cholesterol and slightly high >blood pressure.I am also seeing an ENT on Friday because I did have a long >time cocaine problem that i kicked at the beginning of the year and i am >wondering if that has something to do with my head issues. Thx for any >advice and sorry this was so long.

Response:

Well I got back from the eye doctor and he said my cornea is thicker then normal and my pressure in both eyes was 19..the 3D picture showed that my eyes were both in decent shape and the cupping while larger then normal may be normal for me..I am going back in 4 months for a pressure test and will keep an eye on it..now to find out why my head feels so terrible , I did an MRI and it came back fine but the pressure through out my scalp and weird feelings and tingling and headaches are really incredibly hard for me to deal with.. "Anthony" <optim…@optonline.net> wrote in message

news:w1KDe.240$mf5.143@fe12.lga… – Hide quoted text — Show quoted text -> Also is there any proven methoed to cut down on the floaters I am seeing , > I was told there isn’t anything to be done about it but figured I would > ask here.. > "Anthony" <optim…@optonline.net> wrote in message > news:50KDe.239$mf5.142@fe12.lga… >> The person who is doing the eye exams isnt even a opthmologist its an >> optomitrist ..when i went to him I had no clue I had any problems. I just >> went because my union sent me to him to see if I needed glasses , but he >> has all the machines to do the full testing for Glaucoma..I think no >> matter what happens today I need to go to get a 2nd opinion. You said >> this below >> I used Xalatan for 5 years >> before I had trabeculectomies >> What is trabeculectomies , some kind of surgery? Is Xalatan relatively >> safe? Thanks a lot for your reply. >> "Sherry" <she…@excite.com> wrote in message >> news:Xns96998A92DFD98TansyRagwortNetscape@216.196.97.142… >>> "Anthony" <optim…@optonline.net> wrote in >>> news:LNUCe.150047$mx5.73941@fe08.lga: >>>> I may have glaucoma , I will know more on Thursday..the cups in both >>>> eyes are enlarged and the pressure in both eyes is high although I >>>> don’t know the exact number of my IOP. Anyway I passed the >>>> peripheral vision test and i took a test for blood flow to the eyes >>>> and the doctor said that it was fine as well..On thursday I get more >>>> of the pressure tests , a cornea thickness test and a laser 3D pic >>>> of my eye ( the last pic he took to see the cup was a big polaroid >>>> machine pic )..the problems I have been having though I don’t >>>> believe are related to my eye problems..he also said i was far >>>> sighted and near sighted and needed reading glasses which he gave >>>> me..the reason i went there is i felt a strange pain in my left side >>>> of my forehead..the next day my left eye was blurry and had a lot of >>>> floaters and my head felt like it was under enormous pressure…all >>>> around my temples and top of my head..I also had an MRI which was >>>> negative..can glaucoma give you a lot of head pressure/pain and if i >>>> do have glaucoma what is the best medicine (eyedrops i guess)  i can >>>> take for it , i dont want to screw with my heart at all as I have >>>> pac’s and high cholesterol and slightly high blood pressure.I am >>>> also seeing an ENT on Friday because I did have a long time cocaine >>>> problem that i kicked at the beginning of the year and i am >>>> wondering if that has something to do with my head issues. Thx for >>>> any advice and sorry this was so long. >>> Anthony, >>> I’m not a doc, just a fairly-well educated glaucoma patient.  Glaucoma >>> is diagnosed by damage to the optic nerve.  Elevated pressure is only >>> one of the glaucoma risks (there are people who have elevated pressures >>> and never develop glaucoma and there are people who have normal >>> pressures with glaucoma!)  It looks like you’re getting a really >>> thorough exam.  That’s great!  So many people get an elevated pressure >>> and the eye docs says "you’ve got glaucoma. Here are drops.  Go home >>> and use them!" >>> Glaucoma can can pain if you have acute angle closure or really super >>> high pressures, but it’s eye pain, not a headache as normally >>> experienced.  BTW, migraines can also be a risk factor for glaucoma! >>> I’m glad the MRI was negative. >>> If and when your glaucoma specialist (you are seeing one, right?) >>> prescribes drops, he’ll be the one to determine which ones would be >>> best for you. I know with me it was trial and error to find the ones >>> that worked for me and didn’t have insufferable adverse reactions. >>> Many glaucoma patients get a great drop in IOP with beta blocker drops >>> – I couldn’t tolerate them (I got migraines!).  There is a new class >>> called prostaglandin analogues – Xalatan, Lumigan and Travatan – all >>> which work very well for most people.  I used Xalatan for 5 years >>> before I had trabeculectomies.  (It was the 6th drug my eye doc tried >>> on me – the others either gave me serious side effects, allergic >>> reactions or just weren’t effective!  But not everyone has this >>> problem, so don’t despair!) >>> If and when you do get drops prescribed, be sure to use them faithfully >>> and to use good punctal occlusion techniques to keep the meds from >>> going down the tear ducts and getting absorbed into your system (well, >>> a bit will be absorbed, but this will minimize the amount).  There’s a >>> good video at http://www.nyee.edu/video.html "How to Put Drops in Your >>> Eyes: The Ritch-Sussman Technique" which shows you how. >>> Good luck and keep us posted! >>> Sherry

Response:

He used the table mounted blue light , and i did a peripheral vision test where i had to do one eye at a time looking dead center of some machine while lights flashed on and off all around the place and when i seen a light i was to press a button , i did fine on that test he said.. "Laura" <mcki…@hotmail.com> wrote in message

news:qbh0e15j7jmdo3vijic2hbbvsvrbn3q4fm@4ax.com… – Hide quoted text — Show quoted text -> Sounds like your optometrist is pretty knowledgeable.  Nevertheless > I’m another who thinks you should get a 2nd opinion, from an > OPHTHALMOLOGIST. > Two thoughts come to mind: > 1.  What did he use to check your pressure?  I’ve found hand-held > devices are not very reliable.  It’s better to use a that Goldmann > (sp?) thing, a table mounted device characterized by a blue light. > 2.  Did he do any kind of field testing? > Laura > On Thu, 21 Jul 2005 15:40:02 -0400, "Anthony" <optim…@optonline.net> > wrote: >>Well I got back from the eye doctor and he said my cornea is thicker then >>normal and my pressure in both eyes was 19..the 3D picture showed that my >>eyes were both in decent shape and the cupping while larger then normal >>may >>be normal for me..I am going back in 4 months for a pressure test and will >>keep an eye on it..now to find out why my head feels so terrible , I did >>an >>MRI and it came back fine but the pressure through out my scalp and weird >>feelings and tingling and headaches are really incredibly hard for me to >>deal with..

Response:

Sounds like your optometrist is pretty knowledgeable.  Nevertheless I’m another who thinks you should get a 2nd opinion, from an OPHTHALMOLOGIST. Two thoughts come to mind: 1.  What did he use to check your pressure?  I’ve found hand-held devices are not very reliable.  It’s better to use a that Goldmann (sp?) thing, a table mounted device characterized by a blue light. 2.  Did he do any kind of field testing? Laura On Thu, 21 Jul 2005 15:40:02 -0400, "Anthony" <optim…@optonline.net> wrote: – Hide quoted text — Show quoted text ->Well I got back from the eye doctor and he said my cornea is thicker then >normal and my pressure in both eyes was 19..the 3D picture showed that my >eyes were both in decent shape and the cupping while larger then normal may >be normal for me..I am going back in 4 months for a pressure test and will >keep an eye on it..now to find out why my head feels so terrible , I did an >MRI and it came back fine but the pressure through out my scalp and weird >feelings and tingling and headaches are really incredibly hard for me to >deal with..

Response:

"Anthony" <optim…@optonline.net> wrote in news:LNUCe.150047$mx5.73941@fe08.lga: – Hide quoted text — Show quoted text -> I may have glaucoma , I will know more on Thursday..the cups in both > eyes are enlarged and the pressure in both eyes is high although I > don’t know the exact number of my IOP. Anyway I passed the > peripheral vision test and i took a test for blood flow to the eyes > and the doctor said that it was fine as well..On thursday I get more > of the pressure tests , a cornea thickness test and a laser 3D pic > of my eye ( the last pic he took to see the cup was a big polaroid > machine pic )..the problems I have been having though I don’t > believe are related to my eye problems..he also said i was far > sighted and near sighted and needed reading glasses which he gave > me..the reason i went there is i felt a strange pain in my left side > of my forehead..the next day my left eye was blurry and had a lot of > floaters and my head felt like it was under enormous pressure…all > around my temples and top of my head..I also had an MRI which was > negative..can glaucoma give you a lot of head pressure/pain and if i > do have glaucoma what is the best medicine (eyedrops i guess)  i can > take for it , i dont want to screw with my heart at all as I have > pac’s and high cholesterol and slightly high blood pressure.I am > also seeing an ENT on Friday because I did have a long time cocaine > problem that i kicked at the beginning of the year and i am > wondering if that has something to do with my head issues. Thx for > any advice and sorry this was so long.

Anthony, I’m not a doc, just a fairly-well educated glaucoma patient.  Glaucoma is diagnosed by damage to the optic nerve.  Elevated pressure is only one of the glaucoma risks (there are people who have elevated pressures and never develop glaucoma and there are people who have normal pressures with glaucoma!)  It looks like you’re getting a really thorough exam.  That’s great!  So many people get an elevated pressure and the eye docs says "you’ve got glaucoma. Here are drops.  Go home and use them!" Glaucoma can can pain if you have acute angle closure or really super high pressures, but it’s eye pain, not a headache as normally experienced.  BTW, migraines can also be a risk factor for glaucoma! I’m glad the MRI was negative. If and when your glaucoma specialist (you are seeing one, right?) prescribes drops, he’ll be the one to determine which ones would be best for you. I know with me it was trial and error to find the ones that worked for me and didn’t have insufferable adverse reactions.   Many glaucoma patients get a great drop in IOP with beta blocker drops – I couldn’t tolerate them (I got migraines!).  There is a new class called prostaglandin analogues – Xalatan, Lumigan and Travatan – all which work very well for most people.  I used Xalatan for 5 years before I had trabeculectomies.  (It was the 6th drug my eye doc tried on me – the others either gave me serious side effects, allergic reactions or just weren’t effective!  But not everyone has this problem, so don’t despair!) If and when you do get drops prescribed, be sure to use them faithfully and to use good punctal occlusion techniques to keep the meds from going down the tear ducts and getting absorbed into your system (well, a bit will be absorbed, but this will minimize the amount).  There’s a good video at http://www.nyee.edu/video.html "How to Put Drops in Your Eyes: The Ritch-Sussman Technique" which shows you how. Good luck and keep us posted! Sherry

Response:

o…@astro.as.utexas.edu (Derek Wills) wrote in news:dbrk83$96j$1@geraldo.cc.utexas.edu: >>> What did he use to check your pressure?  I’ve found hand-held >>>devices are not very reliable.  It’s better to use a that Goldmann >>>(sp?) thing, a table mounted device characterized by a blue light. >    I have been around 19 on the latter device (was 24 before >    starting on drops), pretty consistently, at the local bigtime eye >    clinic.   I had an ‘air-puff’ check when I got some new specs >    from the local opticians and the tech said my pressure was 8.   I >    made her do it again, and she got numbers between 7-9.  Both the >    tech and my pro doc just said "different tests give different >    answers" but 8 vs 19??? Something sounds broken.   Perhaps I >    don’t need drops after all – duh. > Derek

The air-puff is notoriously inaccurate.  The Goldmann tonometer is the best! Sherry

Response:

My understanding from my glaucoma specialist is, it isn’t unusual for these hand-helds to be off by around 10 points.  So I don’t find your experience surprising. Before I had my trab last summer, I was in the mid-20’s.  I was sent to a retina specialist to make sure it was OK for me to have the trab. His nurse used a hand-held to check my IOP, and got such a low reading that I went back to my glaucoma specialist for another reading before scheduling the surgery.  All that hand-held did was make me put off surgery a few weeks and generate an unnecessary visit to the doctor. Laura On Fri, 22 Jul 2005 20:17:07 +0000 (UTC), o…@astro.as.utexas.edu – Hide quoted text — Show quoted text -(Derek Wills) wrote: >   I have been around 19 on the latter device (was 24 before starting >   on drops), pretty consistently, at the local bigtime eye clinic.   >   I had an ‘air-puff’ check when I got some new specs from the local >   opticians and the tech said my pressure was 8.   I made her do it >   again, and she got numbers between 7-9.  Both the tech and my pro >   doc just said "different tests give different answers" but 8 vs 19??? >   Something sounds broken.   Perhaps I don’t need drops after all – duh.

Response:

>> What did he use to check your pressure?  I’ve found hand-held >>devices are not very reliable.  It’s better to use a that Goldmann >>(sp?) thing, a table mounted device characterized by a blue light.

   I have been around 19 on the latter device (was 24 before starting    on drops), pretty consistently, at the local bigtime eye clinic.      I had an ‘air-puff’ check when I got some new specs from the local    opticians and the tech said my pressure was 8.   I made her do it    again, and she got numbers between 7-9.  Both the tech and my pro    doc just said "different tests give different answers" but 8 vs 19???    Something sounds broken.   Perhaps I don’t need drops after all – duh. Derek

Response:

I may have glaucoma , I will know more on Thursday..the cups in both eyes are enlarged and the pressure in both eyes is high although I don’t know the exact number of my IOP. Anyway I passed the peripheral vision test and i took a test for blood flow to the eyes and the doctor said that it was fine as well..On thursday I get more of the pressure tests , a cornea thickness test and a laser 3D pic of my eye ( the last pic he took to see the cup was a big polaroid machine pic )..the problems I have been having though I don’t believe are related to my eye problems..he also said i was far sighted and near sighted and needed reading glasses which he gave me..the reason i went there is i felt a strange pain in my left side of my forehead..the next day my left eye was blurry and had a lot of floaters and my head felt like it was under enormous pressure…all around my temples and top of my head..I also had an MRI which was negative..can glaucoma give you a lot of head pressure/pain and if i do have glaucoma what is the best medicine (eyedrops i guess)  i can take for it , i dont want to screw with my heart at all as I have pac’s and high cholesterol and slightly high blood pressure.I am also seeing an ENT on Friday because I did have a long time cocaine problem that i kicked at the beginning of the year and i am wondering if that has something to do with my head issues. Thx for any advice and sorry this was so long.

Response:

LOL lucious eyelashes , this guy told me yesterday he is in fact a glaucoma doctor but he isnt a opthamologist..i told him what others have said and he told me to do as i wish but no other eye doctor will do any different tests then what he just did in our 2 visits. "Sherry" <she…@excite.com> wrote in message

news:Xns969ACD16C8BEBTansyRagwortNetscape@216.196.97.142… – Hide quoted text — Show quoted text -> "Anthony" <optim…@optonline.net> wrote in > news:50KDe.239$mf5.142@fe12.lga: >> The person who is doing the eye exams isnt even a opthmologist its >> an optomitrist ..when i went to him I had no clue I had any >> problems. I just went because my union sent me to him to see if I >> needed glasses , but he has all the machines to do the full testing >> for Glaucoma..I think no matter what happens today I need to go to >> get a 2nd opinion. You said this below >> I used Xalatan for 5 years >> before I had trabeculectomies >> What is trabeculectomies , some kind of surgery? Is Xalatan >> relatively safe? Thanks a lot for your reply. > Anthony, > Yup – trabeculectomy is a glaucoma filtration surgery.  Not something > you want to go through unless drops fail! > I personally had no problems with Xalatan.  I did get nice thick > luscious eyelashes, a side effect of the drug. It can turn blue eyes > brown and darken the skin around the eyes, but most people tolerate it > well. > DEFINITELY go for a second opinion – find a glaucoma *specialist*. If > you’re in the US, go to http://www.glaucomaweb.org/patients/find.htm to > look up one that’s close to you. > Sherry

Response:

"Anthony" <optim…@optonline.net> wrote in news:I94Ee.5923$El3.3530@fe10.lga: > LOL lucious eyelashes , this guy told me yesterday he is in fact a > glaucoma doctor but he isnt a opthamologist..i told him what others > have said and he told me to do as i wish but no other eye doctor > will do any different tests then what he just did in our 2 visits.

Hmm…..  He could have some knowledge about glaucoma and it sounds like he’s pretty well versed with the condition and can do all the tests. *However* a glaucoma *specialist* has the training and experience to accurately interpret all those tests!  I’ve heard of way too many people who have been told they were going to go blind if they didn’t have immediate laser surgery and then went to a glaucoma specialist for a 2nd opinion who said "whaaaa???? you’re fine, use these drops and enjoy many years of good vision"  (Or were even told by the GS that they did *not* have glaucoma and not to worry!) Tell him you appreciate all that he’s done but with a condition as serious as glaucoma, you’d like to get a second opinion. For a long time, I had borderline pressures and questionable optic nerves (high myopia made diagnosis difficult). My ophthalmologist followed me for years, watching everything closely. When the pressures went up a bit and the nerves appeared to change, he sent me to a glaucoma specialist for a definite diagnosis.  Even the glaucoma specialist wasn’t 100% sure, diagnosed me as glaucoma suspect and put me on drops.  Eventually, I had trabeculectomies because there was some slow progression of optic nerve damage – he wanted to get the pressures down into single digits to protect the nerve.  No progression and the IOP is remaining stable. Sherry

Response:

The person who is doing the eye exams isnt even a opthmologist its an optomitrist ..when i went to him I had no clue I had any problems. I just went because my union sent me to him to see if I needed glasses , but he has all the machines to do the full testing for Glaucoma..I think no matter what happens today I need to go to get a 2nd opinion. You said this below I used Xalatan for 5 years before I had trabeculectomies What is trabeculectomies , some kind of surgery? Is Xalatan relatively safe? Thanks a lot for your reply. "Sherry" <she…@excite.com> wrote in message

news:Xns96998A92DFD98TansyRagwortNetscape@216.196.97.142… – Hide quoted text — Show quoted text -> "Anthony" <optim…@optonline.net> wrote in > news:LNUCe.150047$mx5.73941@fe08.lga: >> I may have glaucoma , I will know more on Thursday..the cups in both >> eyes are enlarged and the pressure in both eyes is high although I >> don’t know the exact number of my IOP. Anyway I passed the >> peripheral vision test and i took a test for blood flow to the eyes >> and the doctor said that it was fine as well..On thursday I get more >> of the pressure tests , a cornea thickness test and a laser 3D pic >> of my eye ( the last pic he took to see the cup was a big polaroid >> machine pic )..the problems I have been having though I don’t >> believe are related to my eye problems..he also said i was far >> sighted and near sighted and needed reading glasses which he gave >> me..the reason i went there is i felt a strange pain in my left side >> of my forehead..the next day my left eye was blurry and had a lot of >> floaters and my head felt like it was under enormous pressure…all >> around my temples and top of my head..I also had an MRI which was >> negative..can glaucoma give you a lot of head pressure/pain and if i >> do have glaucoma what is the best medicine (eyedrops i guess)  i can >> take for it , i dont want to screw with my heart at all as I have >> pac’s and high cholesterol and slightly high blood pressure.I am >> also seeing an ENT on Friday because I did have a long time cocaine >> problem that i kicked at the beginning of the year and i am >> wondering if that has something to do with my head issues. Thx for >> any advice and sorry this was so long. > Anthony, > I’m not a doc, just a fairly-well educated glaucoma patient.  Glaucoma > is diagnosed by damage to the optic nerve.  Elevated pressure is only > one of the glaucoma risks (there are people who have elevated pressures > and never develop glaucoma and there are people who have normal > pressures with glaucoma!)  It looks like you’re getting a really > thorough exam.  That’s great!  So many people get an elevated pressure > and the eye docs says "you’ve got glaucoma. Here are drops.  Go home > and use them!" > Glaucoma can can pain if you have acute angle closure or really super > high pressures, but it’s eye pain, not a headache as normally > experienced.  BTW, migraines can also be a risk factor for glaucoma! > I’m glad the MRI was negative. > If and when your glaucoma specialist (you are seeing one, right?) > prescribes drops, he’ll be the one to determine which ones would be > best for you. I know with me it was trial and error to find the ones > that worked for me and didn’t have insufferable adverse reactions. > Many glaucoma patients get a great drop in IOP with beta blocker drops > – I couldn’t tolerate them (I got migraines!).  There is a new class > called prostaglandin analogues – Xalatan, Lumigan and Travatan – all > which work very well for most people.  I used Xalatan for 5 years > before I had trabeculectomies.  (It was the 6th drug my eye doc tried > on me – the others either gave me serious side effects, allergic > reactions or just weren’t effective!  But not everyone has this > problem, so don’t despair!) > If and when you do get drops prescribed, be sure to use them faithfully > and to use good punctal occlusion techniques to keep the meds from > going down the tear ducts and getting absorbed into your system (well, > a bit will be absorbed, but this will minimize the amount).  There’s a > good video at http://www.nyee.edu/video.html "How to Put Drops in Your > Eyes: The Ritch-Sussman Technique" which shows you how. > Good luck and keep us posted! > Sherry

Response:

Hard for me not to be biased here, as I am a fellowship-trained glaucoma specialist and an ophthalmologist.  While the tests that your optometrist are doing, Anthony, sound appropriate, he may not be well-skilled in interpreting them or be up on all of the latest medical studies regarding glaucoma.  It is impossible to know.  Nevertheless, if there is a glaucoma specialist in your town, get a copy of your test results from the optometrist and bring them for a second opinion (so the GS doesn’t have to repeat all of them.)  Sherry is absolutely right here…too often appropriate treatment is delayed because the doctor following you is not on the mark.  An extra opinion could never hurt. Good luck to you. –Rick Cohn, MD Glaucoma Specialist Winter Park, FL

Response:

"Anthony" <optim…@optonline.net> wrote in news:50KDe.239$mf5.142@fe12.lga: > The person who is doing the eye exams isnt even a opthmologist its > an optomitrist ..when i went to him I had no clue I had any > problems. I just went because my union sent me to him to see if I > needed glasses , but he has all the machines to do the full testing > for Glaucoma..I think no matter what happens today I need to go to > get a 2nd opinion. You said this below > I used Xalatan for 5 years > before I had trabeculectomies > What is trabeculectomies , some kind of surgery? Is Xalatan > relatively safe? Thanks a lot for your reply.

Anthony, Yup – trabeculectomy is a glaucoma filtration surgery.  Not something you want to go through unless drops fail! I personally had no problems with Xalatan.  I did get nice thick luscious eyelashes, a side effect of the drug. It can turn blue eyes brown and darken the skin around the eyes, but most people tolerate it well. DEFINITELY go for a second opinion – find a glaucoma *specialist*. If you’re in the US, go to http://www.glaucomaweb.org/patients/find.htm to look up one that’s close to you. Sherry

Response:

Go to Google groups to read all the prior messages posted in alt.support.glaucoma. On Wed, 20 Jul 2005 04:08:11 -0400, "Anthony" <optim…@optonline.net> wrote: – Hide quoted text — Show quoted text ->Damn it figures the group is dead when I arrive , its my bad luck continuing >:( >"Anthony" <optim…@optonline.net> wrote in message >news:LNUCe.150047$mx5.73941@fe08.lga… >>I may have glaucoma , I will know more on Thursday..the cups in both eyes >>are enlarged and the pressure in both eyes is high although I don’t know >>the exact number of my IOP. Anyway I passed the peripheral vision test and >>i took a test for blood flow to the eyes and the doctor said that it was >>fine as well..On thursday I get more of the pressure tests , a cornea >>thickness test and a laser 3D pic of my eye ( the last pic he took to see >>the cup was a big polaroid machine pic )..the problems I have been having >>though I don’t believe are related to my eye problems..he also said i was >>far sighted and near sighted and needed reading glasses which he gave >>me..the reason i went there is i felt a strange pain in my left side of my >>forehead..the next day my left eye was blurry and had a lot of floaters and >>my head felt like it was under enormous pressure…all around my temples >>and top of my head..I also had an MRI which was negative..can glaucoma give >>you a lot of head pressure/pain and if i do have glaucoma what is the best >>medicine (eyedrops i guess)  i can take for it , i dont want to screw with >>my heart at all as I have pac’s and high cholesterol and slightly high >>blood pressure.I am also seeing an ENT on Friday because I did have a long >>time cocaine problem that i kicked at the beginning of the year and i am >>wondering if that has something to do with my head issues. Thx for any >>advice and sorry this was so long.

Response:

William Stacy wrote: > Modern field testers are pretty good at picking up early damage, but > yes, once it shows up on field testing, significant damage has been > done. But since you have no field loss, I would still question the > diagnosis, not because I don’t believe your doctor, but because there is > no precise recipe for that diagnosis that everyone agrees on. I > personally believe that in some cases like yours, unless a change in the > optic nerve can be documented by photography or other optic nerve > imaging, the diagnosis may be premature. Ergo, the 2nd opinion, and if > they disagree, get a 3rd and go with the concensus.  You’ve got lots of > time.

Is it always true that there is significant damage once a visual field test shows a defect? In my case, if there weren’t a repeatable visual field defect (it is mild but widespread) I think I would still be considered a glaucoma suspect because with normal eye pressures and a deceptively healthy looking optic nerve, there wouldn’t be much else to go on, other than a borderline sector in HRT. Despite the visual field defect I was told my case is early or mild. I wish it could have been caught before there was any vision loss but as I said, with normal pressures and myopic disks I understand it can be hard to diagnose. -Gudrun

Response:

Glaucoma is a disease that is much less likely to take your sight when it is diagnosed early and managed well.  For example, when Kirby Puckett of the Minnesota Twins "suddenly" went blind from glaucoma, his pressure was over 50!  He now lectures young athletes all over the world about the dangers of being a glaucoma patient for years without being diagnosed or treated until a disaster occurs. Your doctor is being very cautious and being protective of your sight. Xalatan is a superior glaucoma drop in that it has been shown to not only lower the pressure on the optic nerve, but is has also shown an ability to protect the optic nerve from damage in the future by shielding the nerve from future damage.   This drug and others in its class are all less than 10 years old, so "old" studies of blindness from glaucoma are not as relevant because the nature of the disease and our ability to treat it has changed so much for the better.

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The more you study the history of headache research and pain management, the more you realize how much we just don’t  know about this stuff.  A trigger for a migraine can be any other kind of pain.  I had a patient with visual migraines so bad that she would pull off the road and weep for hours until her aura would go away or she fell asleep.  After every test known to man to rule out a brain tumor, etc…she  accidentally found the trigger that started her migraines…at the dentist!!    She had an impacted wisdom tooth on one side that was so bad that the nerve pain in her jaw would go from her jaw back to the visual cortex, causing her the intense visual migraines.  Three months and two root canals later, she is pretty much migraine free. So, do I think that the two (LTG and migraine) can be related?  Yes, in the sense that all pain can be related because the body has an ability to transfer pain.  I can’t imagine your migraine as a "cause" of glaucoma, but I can more rationally see the glaucoma causing a migraine. Let’s not even touch that left brain/right brain stuff.  It gives me a migraine.

Response:

By definition, normal tension glaucoma is harder to diagnose and is often left untreated for extended periods of time because it is often undiagnosed for years.  So, your question is unfair in a certain way. For example, the recent statistics from the National Transportation Safety Board concluded that minivans had less crashes per thousand vehicles than any other kind of vehicle, and there were fewer fatalities per thousand vehicles.  Can you conclude from those statistics that minivans are the safest vehicle to drive?  No, you can only conclude that the KIND OF PERSON that drives a minivan is the least likely kind of person to crash and die.  So, since you are an early diagnosed LTG patient who is being watched closely with nerve-protecting prophylactic care, you are more likely to save your sight than the "average" LTG patient. – Hide quoted text — Show quoted text -buywhe…@hotmail.com wrote: > I am happy to know that Xalatan does more than lowering IOP, since I > read that for normal tension glaucoma there are some other mysterious > factors that contribute to optic nerve cells dying off, rather than > just high eye pressure. > If you are a clinician would you mind telling me if NTG are more > difficult to treat and has a higher rate of vision loss, even with > treatment, when compare with POAG ? > Thanks again for your time.

Response:

Oh and by the way, if the larger cup belongs to a larger nerve (disk), it is completely normal.  It’s more suggestive if the nerves are equal, and very suspicious if it is on a smaller nerve. – Hide quoted text — Show quoted text -> Asymetrical cups are always a red flag, but it is so common that by > itself it is just another relative risk factor. I’d be more suspicious > if there was a concurrent difference in i.o.p. > w.stacy, o.d.

Response:

I doubt it because pain is not a part of glaucoma except in very high pressures.  But I would look at the individual medications and any effect they might have on eye pressure could be significant. w.stacy, o.d. – Hide quoted text — Show quoted text -buywhe…@hotmail.com wrote: > Thanks for the analysis, I think what you have said is logical. I hope > you don’t mind if I ask another question: since I am a migraine > patient, do you think treating migraine itself will some how help my > glaucoma ? It is very interesting because when I have a migraine > attack, the pain is always on the right side of my head. And it is my > left eye which has glaucoma. From my very limited anatomy knowledge I > know the left eye is actually connected to the right brain. May be the > two conditions are somehow related ?

Response:

buywhe…@hotmail.com wrote: > Just to have an idea if someone with an earlier stage of glaucoma > receive no treatment at all, how long does it take for her to loss > peripherial vision, and how long to loss central vision ? Is there any > general trend in this ? I know every case is different, but is there > any concensus on the natural history of this illness ?

The disease has many different variables, knowns, unknowns, courses, and treatments.  And different experts will give you different opinions. Add to that the theories are changing as more is learned.  There are some things that are pretty well "concensus" but not all. It really does vary   from eye to eye. I know it sounds screwy, but there is a lot we don’t know about this disease. > I don’t know who is considered a glaucoma specialist, but I think more > than half of his patients see him for glaucoma. I was told I have > normal tension open angle glaucoma. Thanks for the suggestion I will > ask how it will affect my occupation.

Glaucoma specialists limit their practices to glaucoma cases.  Sounds like he might be a general ophthalmologist with a "special interest" in glaucoma. > No, none of my visual field test shows anything unusual, so my > diagnosis was based on the condition of my optic nerve. I was told that > it takes quite some damage to have an effect on visual field. Is that > correct ?

Modern field testers are pretty good at picking up early damage, but yes, once it shows up on field testing, significant damage has been done. But since you have no field loss, I would still question the diagnosis, not because I don’t believe your doctor, but because there is no precise recipe for that diagnosis that everyone agrees on. I personally believe that in some cases like yours, unless a change in the optic nerve can be documented by photography or other optic nerve imaging, the diagnosis may be premature. Ergo, the 2nd opinion, and if they disagree, get a 3rd and go with the concensus.  You’ve got lots of time. w.stacy, o.d.

Response:

Of course I will be second guessing your doc but I’m wondering a bit about the diagnosis.  Was it based on sequential HRT’s  or what?  Did he/she see any enlargment of the cups over time?  .6 and .4 are not particularly big cups for a myope with large discs, and 19 is not all that high for iop.  Sounds like you’ve got lots of nerve tissue there, and while nobody can predict with certainty, I’d be surprised if you were to become blind any time in your life, especially with all the advancements in the field that have and will take place. w.stacy, o.d. – Hide quoted text — Show quoted text -buywhe…@hotmail.com wrote: > I am 39 and was diagnosed with glaucoma in my left eye last week. My > doctor made the diagnosis after a HRT was done. My cup disk ratio is > 0.64 on my left eye, 0.45 on my right eye. My doctor said there was > some obvious damage in the left eye. My eye pressure are around 19 for > both eyes. I am myopic and my disks are very large to begin with (4 > mm), and I am also have migraine, and my doctor has called me a suspect > for two years. > I was put on Xalatan and my doctor said not to worry too much. He said > we will treat the other eye too. > My understanding is most glaucoma patients are elderly, and may be most > of them don’t live long enough to go blind anyway. My question is does > anybody know of any statistics of young patients going blind ? I still > have 36 years ahead if I can live to the age of 75. May be I won’t go > blind in the next 10 years. But what about 20 or 30 years later ? > I will appreciate if some of you can point me to any statistics/studies > or personal experience. I want to plan ahead if I know I am going to be > blind sometime down the road. > Thanks.

Response:

buywhe…@hotmail.com wrote: > Thanks for the suggestion. I will definitely go seek a second and third > opinion. But William, do you agree that most cupping in normal eyes are > symmetrical between the two eyes, no matter if they are small or large > ?

Asymetrical cups are always a red flag, but it is so common that by itself it is just another relative risk factor. I’d be more suspicious if there was a concurrent difference in i.o.p. w.stacy, o.d.

Response:

buywhe…@hotmail.com wrote: > Thank you for your kind words William, I chope what you have said will > come true. But since I have kids to take care of I need to be realistic > and plan ahead … (eg. start a new career which a low vision/blind > person can do, may be ?)

Most glaucomas are slow to take vision, usually affecting peripheral vision long before central vision goes, usually taking years to even be noticed by the patient. > To answer your question, no, my diagnosis was not based on sequential > HRTs. It was based on one single HRT. My doctor said based on his > experience the shape of my left nerve cup is definitely due to > glaucoma. He has been suspicious about my cupping for two years.

Maybe I’m not as sure about HRT as he is.  But again I’m second guessing.  Anyway, I’m suspicious enough to recommend a 2nd opinion by a glaucoma specialist.  After all, we are talking about a life sentence of eyedrops/what-have-you treatment and expensive monitoring.  If your doc is a glaucoma specialist, then fine, ask him how soon your type will/can cause you occupational problems.   I have heard some stories about people successful in maintaining > their eye sight for 20 or even 30 years. But I guess there must be a > lot of failure examples too.

Sure, most people do not outlive their glaucoma. BTW did you do visual fields?   Any demonstrable field defect? If so, I’ll yield to that, but if not, get that 2nd opinion and be sure to report back here. w.stacy, o.d.

Response:

Anterior ischemic optic neuropathy (AION) is not similar to glaucoma in symptoms or etiology.  AION is very much like a stroke to the optic nerve that causes immediate and usually permanent visual loss (although not complete…patients are often 20/400, and the loss may only involve the upper or lower half of the vision).  This is from blockage of bloodflow to the optic nerve in the tiny, microscopic vessels that bring blood to the nerve head.  It is common in elderly patients with hypertension and/or diabetes (usually the same group who use Viagra). The optic nerve will look swollen but not cupped out as in glaucoma. IOP is seldom if ever a factor in AION.  AION almost always occurs in one eye only.      Conversely, the vision loss from glaucoma is usually rather slow (over many years), is often but not always associated with elevation in IOP, and may not be noticed by the patient until advanced loss has occured.  There is often no significant association with systemic hypertension.  As many of these articles on Viagra have mentioned, it is hard to say if there is a true cause and effect between Viagra use and AION.  This is because many of those who use Viagra have the same risk factors for developing AION.  This will need to be studied further.  Meanwhile, remember that the number of cases of AION have been relatively few compared to the millions who use these drugs in this country.  I know if I needed Viagra to have a better sexlife, I wouldn’t be throwing away my little blue pills just yet. Hope that was useful. –Rick Cohn, MD Glaucoma Specialist

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In article <1117497318.853728.149…@g49g2000cwa.googlegroups.com>, – Hide quoted text — Show quoted text - eyegu…@aol.com wrote: > Anterior ischemic optic neuropathy (AION) is not similar to glaucoma in > symptoms or etiology.  AION is very much like a stroke to the optic > nerve that causes immediate and usually permanent visual loss (although > not complete…patients are often 20/400, and the loss may only involve > the upper or lower half of the vision).  This is from blockage of > bloodflow to the optic nerve in the tiny, microscopic vessels that > bring blood to the nerve head.  It is common in elderly patients with > hypertension and/or diabetes (usually the same group who use Viagra). > The optic nerve will look swollen but not cupped out as in glaucoma. > IOP is seldom if ever a factor in AION.  AION almost always occurs in > one eye only. >      Conversely, the vision loss from glaucoma is usually rather slow > (over many years), is often but not always associated with elevation in > IOP, and may not be noticed by the patient until advanced loss has > occured.  There is often no significant association with systemic > hypertension.  As many of these articles on Viagra have mentioned, it > is hard to say if there is a true cause and effect between Viagra use > and AION.  This is because many of those who use Viagra have the same > risk factors for developing AION.  This will need to be studied > further.  Meanwhile, remember that the number of cases of AION have > been relatively few compared to the millions who use these drugs in > this country.  I know if I needed Viagra to have a better sexlife, I > wouldn’t be throwing away my little blue pills just yet. > Hope that was useful. > –Rick Cohn, MD > Glaucoma Specialist

* Dr. Cohn — Thanks for your usual explanation of a complex subject. I have a suggestion:  When you post to alt.support.glaucoma you should send a copy of your posting to:    glauc…@yahoogroups.com This would then appear on the Glaucoma mailing list that Yahoo maintains.  Dr. Robert Ritch is the resident Guru there, but he is extremely busy and could use a little help! Many thanks!  Keep up the good work. earle * Diagnosed in 1970 — tried every drop in the book.  Bilateral trabs about six years ago — now age 74 with IOP 15/17 (with no drops) and acuity 20:20 with one diopter of correction.

Response:

The FDA reported that a small number of men (49) who took Viagra and 1 who took cialis developed non-arteritic anterior ischemic optic neuropathy. From the AP News Quote: > It can occur in men who are diabetic or have heart disease, the same

conditions that can cause impotence and thus lead to Viagra use. That neuropathy is a disease whose symptoms are not dissimilar to glaucoma, although the etiology is presumed different. All of us men taking drops to resolve high IOP should be aware of the possible effects of ED drugs, particularly if we have already had some nerve damage. My very non-professional opinion is that extensive daily aerobic exercise not only lowers IOP (published data supports that) but also substantially reduces or eliminates age related ED (personal anecdotal evidence, I know of no published study to support this claim). Exercise sure beats taking drugs, and you are never too old to start excercising!  

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>It can also cut down on the long-term cost of medications, he said. >"The surgery pays for itself in under three years," he said. "There is no >question that there are cost savings."

If there is no question, then there’s no need for legislation. Does anybody believe that if this saved insurance companies money that they wouldn’t already cover it? But I think what would probably happen is that many more people would opt for the bypass surgery if it was covered, thus throwing any cost savings projections out the window.

Response:

States weigh covering obesity surgery Risks, costs debated in several states HARTFORD, Connecticut (AP) — Jacqueline Ezell says she felt as if she were drowning when she was rushed to the hospital four years ago. At 288 pounds, doctors had already diagnosed her with diabetes, glaucoma and high cholesterol, all side effects of obesity. She also had heart problems. "I couldn’t breathe," Ezell said. Doctors gave Ezell two options. She could seek a heart transplant, or have gastric bypass surgery. She chose the surgery. The Preston woman recently told Connecticut lawmakers that she went from a size 26 to a size 6. The surgery also helped lower her cholesterol, and she was taken off a heart transplant waiting list. Now, the only medications she needs are for her heart condition. "There’s nothing I can’t do now," she said. A proposal is before Connecticut lawmakers that would require insurance companies to cover the surgery for people with a body-mass index of 30 or more if a doctor deems the surgery medically necessary. The BMI is a widely used formula based on height and weight. The Connecticut proposal may not get off the ground this session because lawmakers are struggling to define under what medical conditions the surgery should be covered, said Sen. Joseph Crisco, a Woodbridge Democrat who chairs the legislative committee looking at the issue. Benefits vs. risks The debate is not unlike others across the country. Georgia lawmakers are considering a similar bill this year. And in Louisiana, 40 state employees were chosen last year from 1,200 applications to get the surgery on the state’s dime. The standard surgery, which can cost between $20,000 and $35,000, involves using staples to separate a small pouch at the stomach’s top from the rest of the stomach, greatly limiting the amount of food that can be eaten. The procedure also involves bypassing much of the small intestine so that less food is absorbed into the body. Blue Cross and Blue Shield of Alabama recently stopped paying for the operations while it decides how to handle claims; Blue Cross and Blue Shield of Florida has also decided to stop paying for the operation. In Connecticut, many major plans offer coverage only for large numbers of employees. Others are considering offering the coverage for an additional charge. "What we’re starting to see is an increase in what we would consider at best, unnecessary, and at worst, unsafe, surgery," said Keith Stover, a lobbyist for the Connecticut Association of Health Plans. "Many plans decide the best course of action simply is to exclude coverage." But many physicians say the long-term benefits of weight loss surgery outweigh the risk. Gastric bypass surgery can help cure obesity-related health problems such as high cholesterol, high blood pressure, sleep apnea and even diabetes, said Dr. Jonathan Aranow, director of the Middlesex Hospital Center for Obesity Surgery. It can also cut down on the long-term cost of medications, he said. "The surgery pays for itself in under three years," he said. "There is no question that there are cost savings." Last year the federal government opened the door for Medicare coverage of gastric bypass surgery. But some lawmakers and insurers are also worried about risks. State Rep. Anthony D’Amelio, R-Waterbury, said noted two people in his district died after having the operation. Complications strike as many as 1 in 5 patients having the surgery, and it is believed that for every 200 patients, 1 to 4 will die. Estimates are that more than 100,000 people will have the surgery this year. "I would rather see people try to do it the harder way, exercise and eating properly," D’Amelio said. "I know it’s a struggle … I think it’s the safest route." But for some patients, the hard way hasn’t worked. Deborah Sicaras, 36, of Wethersfield, has tried Weight Watchers, Jenny Craig, diet pills and liquid diets; she also teaches ballet, tap and jazz four days a week. "I’m one of the fortunate ones who will be able to have this surgery in the very near future," she said. "I can’t do this by myself. I need assistance. I’ve dieted my whole life."

Response:

Hi, all, My internist is suggesting I switch from Allegra-D pills to Nasonex nasal spray to treat my allergies because of dry-mouth problems. However, I’m concerned because it’s a corticosteroid. Does anyone know anything about its safety for glaucoma patients? Thanks, Laura

Response:

On Mon, 18 Apr 2005 23:42:57 GMT, Laura <mcki…@hotmail.com> wrote: >Hi, all, >My internist is suggesting I switch from Allegra-D pills to Nasonex >nasal spray to treat my allergies because of dry-mouth problems. >However, I’m concerned because it’s a corticosteroid. >Does anyone know anything about its safety for glaucoma patients? >Thanks, >Laura

The best treatment is to get shots to build up your tolerance so that you can stop taking any of those drugs.  Why not see an allergist for the problem? I think the type of Glaucoma you have is important in determining whether or not steroid medication can be a problem.  Best to discuss with the Dr treating your Glaucoma. Cheers,  Ann To email: replace ‘REMOVE’ with ‘b’ in email address.

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Hi Tom How can you seriously contemplate using an illicit drug, which has never had any research attached to it, and is acknowledged as being harmful to your general system, to address a local (eye) problem when you cannot measure the effectiveness of the treatment, since no qualified practitioner would ever agree to monitor your progress, as they would be implicated in an illegal act and could jeopardise their Practicing License.  Please understand that all drugs can have side-effects, which vary from person to person, but your probability of successful, long term treatment on correct Doctor-prescribed drugs is much higher than your probability of success using a non-recognised, non-regulated and non-controlled course of action.  I don’t know how old you are, but you must also consider the effect of using marijuana for decades, and also consider that this course of action will prevent you from ever boarding an international flight, as you will not be able to take your stash with you. I beg you to think carefully about this course of action. Best wishes for Christmas Mark Optometrist Sydney, Australia "tom" <l…@home.com> wrote in message

news:F45wd.576635$D%.503257@attbi_s51… – Hide quoted text — Show quoted text -> I have been studying the drug options for > glaucoma.  I dont have any idea with regards to > effectiveness, but there is no doubt in my mind > anyway that marijuana is far and away the safest > of all the alternatives. > I am a bit scared of taking any of the other > medications for any period of time.  They all > seem to be very potent and dangerous drugs > if they enter the bloodstream.

Response:

I don’t know.  I guess that would be more for the doctor to answer.  I do know that with certain preservative-free products, such as single-use lubricant vials like Bion Tears, I have to be more careful and use them within a certain amount of time after opening the packet because they don’t have preservatives.  I still use them because some preservatives irritate my eyes. Laura – Hide quoted text — Show quoted text -On Wed, 22 Dec 2004 03:12:41 GMT, "tom" <l…@home.com> wrote: >So is there any more danger of infection with glaucoma >eye drops than there is for soft contact lens rewetting >solution for example?  It seems from reading the >product information for these drugs that the bottle >is easily contaminated.

Response:

"Sun Chong Hong" <n…@spam.com> wrote in message news:cpujt6$mdm$1@mawar.singnet.com.sg… > Check out the information provided here: > http://www.mfiles.org/Marijuana/medicinal_use/b3_glaucoma.html > Sun Chong Hong

Lets hear from the other side: http://www.marijuanamyths.com/med-glaucoma.php3 It is interesting that anti-marijuana website contains blatant falsehoods where this website is much more careful with the facts. One question in particular.  What side effect or danger would there be in taking a large oral dose of marijuana before bedtime?

Response:

While it is true that the harmful side effects of marijuana may be overstated, it has not been found to be a useful IOP-lowering agent because of its short duration of action.  In order to keep your IOP low enough to protect your optic nerve, you would have to be stoned 24/7. Hard to go around leading a productive life that way.  Also, last time I checked it was…ILLEGAL!!! While we’re talking about "overstating" and "not knowing what you are talking about," lets address your comments about death and blindness from glaucoma drops.  In my nine years as a glaucoma specialist and twelve years treating eye diseases, I have only seen ONE patient admitted to the hospital as a result of glaucoma treatment (an asthmatic patient became short of breath on Betoptic S…he did fine with oxygen, a nebulizer treatment, and discontinuation of the drops). I have seen no deaths or blindness caused by these drops in over 10,000 patients I have treated.  The worst ocular side effect I have seen from these drops has been allergy or corneal irritation, which goes away after you stop them.  Systemically, I have seen fatigue or depression from Alphagan or Timoptic.  As for long track records, while these drops haven’t been around for thousands of years, many have been around for decades (Timoptic’s been around for over 30 years…that’s not enough for you?).  Most of these drops, like Xalatan, for instance, have been around almost 10 years and were in research for several years before that.  Xalatan is safe and effective and is an excellent medication…I’m certain it has prevented many of my patients from losing sight to glaucoma. I agree with others here that it sounds like you are just looking for a way to get cheaper and legalized recreational pot…don’t waste our time promoting it as a useful glaucoma therapy. –Rick Cohn, MD Glaucoma Specialist Winter Park, FL

Response:

"Steve" <no.tha…@nospam.net> wrote in message

news:s4qwd.1144$_t4.35@newsfe2-win.ntli.net… – Hide quoted text — Show quoted text -> tom wrote: > > I have been studying the drug options for > > glaucoma.  I dont have any idea with regards to > > effectiveness, but there is no doubt in my mind > > anyway that marijuana is far and away the safest > > of all the alternatives. > > I am a bit scared of taking any of the other > > medications for any period of time.  They all > > seem to be very potent and dangerous drugs > > if they enter the bloodstream. > Bad idea, I have heard that Marijuana is used as a painkiller for pain > in chronic conditions like MS, Glaucoma etc. It’s not a treatment of > Glaucoma itself and painful eyes are eyes that are self destructing … > It’s a bit like having a broken leg and smoking for the pain. You’d > still put the leg in plaster wouldn’t you?

Marijuana lowers the pressure in your eye.  Your analogy is not quite accurate.  In fact you dont know what you are talking about.

Response:

I have been studying the drug options for glaucoma.  I dont have any idea with regards to effectiveness, but there is no doubt in my mind anyway that marijuana is far and away the safest of all the alternatives. I am a bit scared of taking any of the other medications for any period of time.  They all seem to be very potent and dangerous drugs if they enter the bloodstream.

Response:

"tom" <l…@home.com> wrote in news:Pasxd.528834$wV.376588@attbi_s54: <snip> > Dr. Cohn wrote the following: > "While it is true that the harmful side effects of marijuana may be > overstated, it has not been found to be a useful IOP-lowering agent > because of its short duration of action.  In order to keep your IOP > low enough to protect your optic nerve, you would have to be stoned > 24/7." > I would be grateful if Dr. Cohn posted the details of any scientific > studies which lead to this conclusion.

I’m not Dr. Cohn, but you can find reference here   http://www.medmjscience.org/Pages/reports/nihpt4.bhtml (first reference that came up when I did a google search on "marijuana iop") "The dose of marijuana necessary to produce a clinically relevant effect in the short term appears to produce an unacceptable level of undesirable side effects such as euphoria, systemic hypotension, and/or dry eye and conjunctival hyperemia in the majority of glaucoma patients in whom the drug has been carefully studied. No data have been published on studies of long-term ocular and systemic effects of the use of marijuana by glaucoma patients." Mind you, hypotension is a serious risk factor *for* glaucoma.   Glaucoma is *not* elevated intraocular pressure, but damage to the optic nerve and if the optic nerve isn’t well "fed" by an adequate blood supply, damage will ensue. A study done in 1975 indicated that the IOP returned to baseline about 4 hours after smoking. The Glaucoma Research Foundation also has an article on their website at http://www.glaucoma.org/treating/treatment/marijuana.html which states "The high dose of marijuana necessary to produce a clinically relevant effect on IOP in the short term requires constant inhalation, as much as every three hours. The number of significant side effects generated by long-term oral use of marijuana or long-term inhalation of marijuana smoke make marijuana a poor choice in the treatment of glaucoma, a chronic disease requiring proven and effective treatment." Sherry

Response:

Tom, I did not read any opposite agenda in Dr. Cohn message. Instead, I always have seen him, for a long time, trying to help us, glaucoma sufferers, explaining and clarifying many aspects of the disease. Small pupil ( a glaucoma sufferer) Tom wrote:

" <eyegu…@aol.com> wrote in message

news:1103335401.798055.175620@z14g2000cwz.googlegroups.com… > While it is true that the harmful side effects of marijuana may be >—

Product information about Xalatan: http://www.pfizer.com/download/uspi_xalatan.pdf This does not strike me as exactly safe, and this is the research from Pfizer and we can see with Celebrax that we cannot be completely confident in that which a drug company says about their product when they are making so much money from their product. I am also disturbed that you are impugning my motives here.  This suggests that you have an agenda.  I do have an agenda, which is to find out as much as possible about all possible treatments to reduce IOP.  Apparently your agenda is exactly the opposite. "

Response:

Check out the information provided here: http://www.mfiles.org/Marijuana/medicinal_use/b3_glaucoma.html Sun Chong Hong

Response:

<eyegu…@aol.com> wrote in message

news:1103335401.798055.175620@z14g2000cwz.googlegroups.com… – Hide quoted text — Show quoted text -> While it is true that the harmful side effects of marijuana may be > overstated, it has not been found to be a useful IOP-lowering agent > because of its short duration of action.  In order to keep your IOP low > enough to protect your optic nerve, you would have to be stoned 24/7. > Hard to go around leading a productive life that way.  Also, last time > I checked it was…ILLEGAL!!! > While we’re talking about "overstating" and "not knowing what you > are talking about," lets address your comments about death and > blindness from glaucoma drops.  In my nine years as a glaucoma > specialist and twelve years treating eye diseases, I have only seen ONE > patient admitted to the hospital as a result of glaucoma treatment (an > asthmatic patient became short of breath on Betoptic S…he did fine > with oxygen, a nebulizer treatment, and discontinuation of the drops). > I have seen no deaths or blindness caused by these drops in over 10,000 > patients I have treated.  The worst ocular side effect I have seen from > these drops has been allergy or corneal irritation, which goes away > after you stop them.  Systemically, I have seen fatigue or depression > from Alphagan or Timoptic.  As for long track records, while these > drops haven’t been around for thousands of years, many have been around > for decades (Timoptic’s been around for over 30 years…that’s not > enough for you?).  Most of these drops, like Xalatan, for instance, > have been around almost 10 years and were in research for several years > before that.  Xalatan is safe and effective and is an excellent > medication…I’m certain it has prevented many of my patients from > losing sight to glaucoma. > I agree with others here that it sounds like you are just looking > for a way to get cheaper and legalized recreational pot…don’t waste > our time promoting it as a useful glaucoma therapy. > –Rick Cohn, MD > Glaucoma Specialist > Winter Park, FL

I am not very vain, but if my choice is between being stoned all day long or changing the color of these baby blues, I rather be stoned all day long.

Response:

On Thu, 16 Dec 2004 00:58:13 GMT, "tom" <l…@home.com> wrote: >I have been studying the drug options for >glaucoma.  I dont have any idea with regards to >effectiveness, but there is no doubt in my mind >anyway that marijuana is far and away the safest >of all the alternatives. >I am a bit scared of taking any of the other >medications for any period of time.  They all >seem to be very potent and dangerous drugs >if they enter the bloodstream.

I seriously doubt that you will find much useful, accurate or impartial information about the medical uses of cannabis in the current American political climate. ++++++++++++++++++++++++++++++++++++++++++ REMEMBER TO VOTE… "NONE OF THE ABOVE"

Response:

"tom" <l…@home.com> wrote in news:F45wd.576635$D%.503257@attbi_s51: > I have been studying the drug options for > glaucoma.  I dont have any idea with regards to > effectiveness, but there is no doubt in my mind > anyway that marijuana is far and away the safest > of all the alternatives. > I am a bit scared of taking any of the other > medications for any period of time.  They all > seem to be very potent and dangerous drugs > if they enter the bloodstream.

Marijuana is implicated in lung cancer, paranoia, apathy, etc.  It’s only effective at lowering the IOP for a very short period of time so you need to smoke several times a day and can never stop. Don’t worry about using glaucoma drops.  Some have less side effects than others, some people never experience any of the side effects.  I was on Xalatan for 5 years with no problems. Get a good glaucoma specialist and follow his or her instructions for you. Sherry

Response:

"Sherry" <she…@excite.com> wrote in message

news:Xns95C5EE69A7AD7TansyRagwortNetscape@130.133.1.4… – Hide quoted text — Show quoted text -> "tom" <l…@home.com> wrote in news:O5Mxd.216770$5K2.177763@attbi_s03: > <snip> > > I have read studys that indicate the lower your > > blood pressure the better.  I doubt very much > > that hypotension is a problem for the optic nerve. > > I also am not so sure that THC causes hypotension. > "Marijuana and delta9-tetrahydrocannabinol (THC) increase heart rate, > slightly increase supine blood pressure, and on occasion produce marked > orthostatic hypotension." > http://www.cannabis.net/cardiovascular/ > The lower the better for your heart, not your eyes.  Both hypertension > and hypotension have been implicated as possible risk factors for > normal tension glaucoma. > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi? > cmd=Retrieve&db=PubMed&list_uids=10416743&dopt=Abstract > "Patients who had field progression showed significantly lower > nocturnal blood pressure variables, with the dips of the systolic, > diastolic, and mean arterial pressure significantly larger " > > I am wondering if there is anything further on the > > following: > > ". . . Because the possibility exists that marijuana (or its > > components) may be useful in treating glaucoma, the American Academy > > on Ophthalmology Committee on Drugs believes that a long term > > clinical study, designed to test the safety and efficacy of > > marijuana in the prevention of progressive optic nerve damage and > > consequent visual field loss, appears appropriate." > "The American Academy of Ophthalmology (1992) stated: "There is > evidence that marijuana (or its components), taken orally or by > inhalation can lower intraocular pressure. However, there are no > conclusive studies to date to indicate that marijuana (or its > components) can safely and effectively lower intraocular pressure > enough to prevent optic nerve damage. . . . The dose of marijuana > necessary to produce a clinically relevant effect in the short term > appears to produce an unacceptable level of undesirable side effects > such as euphoria, systemic hypotension, and/or dry eye and conjunctival > hyperemia in the majority of glaucoma patients in whom the drug has > been carefully studied. No data have been published on studies of long- > term ocular and systemic effects of the use of marijuana by glaucoma > patients." > http://www.hivpositive.com/f-Nutrition/MedicalMarijuana/MM- > Glaucoma.html > > I have also read the warnings for Xalatan which > > apparently is one of the safer drops to lower IOP. > > I do not understand why infection is an issue with > > this drug and seemingly all the others.  Infection does > > not appear to be an issue with contact lens solution. > > Or visine for that matter. > Infection is a risk with any eye drops if the tip of the bottle and > consequently the fluid itself gets contaminated.  Infection is a > serious problem with glaucoma patients who have had cutting surgery – > trabs, shunts, etc.  Contact lens wearers are not only at risk of > infection but also corneal ulcers.

I guess if you have heart failure or some other cardiovascular disease  you may not want to lower your blood pressure.  But for the most part, low blood pressure is good for your organs. I am pretty certain that low blood pressure is good for your brain, and therefore it must be good for your optic nerve.  I am not a doctor but I would be very surprised to be wrong here. I also dont think that THC reduces blood pressure or this would be another medicinal use for it and I dont think this is the case.  I would be less surprised if I was wrong here there.

Response:

I think I’d like to see the evidence for your claim that marijuana is efficacious in lowering IOP. It would seem that marijuana is often seen as a "cure all" according to some people. Of course it has been around for thousands of years and so has glaucoma but no one seems to have managed to use this readily available substance as anything other than a recreational drug. Research has been carried out here in the UK into the medicinal use of the drug for certain illnesses and conditions. It was reported that it sort of worked for some people in some circumstances. I don’t recall that it was credited with universal curative properties or was even a significant advance in medical science. There were however lots of addicts advocating its use for medical reasons. Most people came to the conclusion that they simply wanted the recreational use of the substance to be made legal. I wonder if that record is playing again? I think that professionals researching treatments would consider any substance, particularly something as cheap as marijuana, without needing much advice. I expect it’s been tried but maybe not. Checkout.

Response:

"Tom" <lf…@spam.net> wrote in message

news:zeidnVE1qv2ig_7fRVn-qg@comcast.com… > It has been suggested that determing whether > marijuana could be effective as a glaucoma > medication would be a long process. > It seems to me that it would not be all that > difficult.  The first step would be to determine > whether oral dosing lowers IOP. > If oral dosing reduces IOP, then marijuana could then > soaked in various solvents and solutions.  If any of > these lowered IOP with oral dosing, then it would > seem natural that direct application to the eye of these > solutions should also lower IOP.

It’s a great pity that marijuana does not reduce imbecility Tom then you might just benefit. Do you suffer from Glaucoma or are you just a troll? Since you reappear here on a regular basis and complain if anyone objects to your outlandish views I think it more likely that the former is correct.

Response:

It has been suggested that determing whether marijuana could be effective as a glaucoma medication would be a long process. It seems to me that it would not be all that difficult.  The first step would be to determine whether oral dosing lowers IOP. If oral dosing reduces IOP, then marijuana could then soaked in various solvents and solutions.  If any of these lowered IOP with oral dosing, then it would seem natural that direct application to the eye of these solutions should also lower IOP.

Response:

Hello again Tom I’m not going to comment on the posting directly, but I would like to say that you have stimulated one of the most interesting discussion threads that I have seen in my time perusing this newsgroup.  Thank you for commencing this thread. Best wishes Mark Schmidt Optometrist Sydney, Australia "tom" <l…@home.com> wrote in message

news:F45wd.576635$D%.503257@attbi_s51… – Hide quoted text — Show quoted text -> I have been studying the drug options for > glaucoma.  I dont have any idea with regards to > effectiveness, but there is no doubt in my mind > anyway that marijuana is far and away the safest > of all the alternatives. > I am a bit scared of taking any of the other > medications for any period of time.  They all > seem to be very potent and dangerous drugs > if they enter the bloodstream.

Response:

"tom" <l…@home.com> wrote in news:O5Mxd.216770$5K2.177763@attbi_s03: <snip> > I have read studys that indicate the lower your > blood pressure the better.  I doubt very much > that hypotension is a problem for the optic nerve. > I also am not so sure that THC causes hypotension.

"Marijuana and delta9-tetrahydrocannabinol (THC) increase heart rate, slightly increase supine blood pressure, and on occasion produce marked orthostatic hypotension." http://www.cannabis.net/cardiovascular/ The lower the better for your heart, not your eyes.  Both hypertension and hypotension have been implicated as possible risk factors for normal tension glaucoma. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi? cmd=Retrieve&db=PubMed&list_uids=10416743&dopt=Abstract "Patients who had field progression showed significantly lower nocturnal blood pressure variables, with the dips of the systolic, diastolic, and mean arterial pressure significantly larger " > I am wondering if there is anything further on the > following: > ". . . Because the possibility exists that marijuana (or its > components) may be useful in treating glaucoma, the American Academy > on Ophthalmology Committee on Drugs believes that a long term > clinical study, designed to test the safety and efficacy of > marijuana in the prevention of progressive optic nerve damage and > consequent visual field loss, appears appropriate."

"The American Academy of Ophthalmology (1992) stated: "There is evidence that marijuana (or its components), taken orally or by inhalation can lower intraocular pressure. However, there are no conclusive studies to date to indicate that marijuana (or its components) can safely and effectively lower intraocular pressure enough to prevent optic nerve damage. . . . The dose of marijuana necessary to produce a clinically relevant effect in the short term appears to produce an unacceptable level of undesirable side effects such as euphoria, systemic hypotension, and/or dry eye and conjunctival hyperemia in the majority of glaucoma patients in whom the drug has been carefully studied. No data have been published on studies of long- term ocular and systemic effects of the use of marijuana by glaucoma patients." http://www.hivpositive.com/f-Nutrition/MedicalMarijuana/MM- Glaucoma.html > I have also read the warnings for Xalatan which > apparently is one of the safer drops to lower IOP. > I do not understand why infection is an issue with > this drug and seemingly all the others.  Infection does > not appear to be an issue with contact lens solution. > Or visine for that matter.

Infection is a risk with any eye drops if the tip of the bottle and consequently the fluid itself gets contaminated.  Infection is a serious problem with glaucoma patients who have had cutting surgery – trabs, shunts, etc.  Contact lens wearers are not only at risk of infection but also corneal ulcers.

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"Sherry" <she…@excite.com> wrote in message

news:Xns95C4D115F50D4TansyRagwortNetscape@130.133.1.4… – Hide quoted text — Show quoted text -> "tom" <l…@home.com> wrote in news:Pasxd.528834$wV.376588@attbi_s54: > <snip> > > Dr. Cohn wrote the following: > > "While it is true that the harmful side effects of marijuana may be > > overstated, it has not been found to be a useful IOP-lowering agent > > because of its short duration of action.  In order to keep your IOP > > low enough to protect your optic nerve, you would have to be stoned > > 24/7." > > I would be grateful if Dr. Cohn posted the details of any scientific > > studies which lead to this conclusion. > I’m not Dr. Cohn, but you can find reference here > http://www.medmjscience.org/Pages/reports/nihpt4.bhtml > (first reference that came up when I did a google search on "marijuana > iop") > "The dose of marijuana necessary to produce a clinically relevant > effect in the short term appears to produce an unacceptable level of > undesirable side effects such as euphoria, systemic hypotension, and/or > dry eye and conjunctival hyperemia in the majority of glaucoma patients > in whom the drug has been carefully studied. No data have been > published on studies of long-term ocular and systemic effects of the > use of marijuana by glaucoma patients." > Mind you, hypotension is a serious risk factor *for* glaucoma. > Glaucoma is *not* elevated intraocular pressure, but damage to the > optic nerve and if the optic nerve isn’t well "fed" by an adequate > blood supply, damage will ensue. > A study done in 1975 indicated that the IOP returned to baseline about > 4 hours after smoking. > The Glaucoma Research Foundation also has an article on their website > at http://www.glaucoma.org/treating/treatment/marijuana.html which > states "The high dose of marijuana necessary to produce a clinically > relevant effect on IOP in the short term requires constant inhalation, > as much as every three hours. The number of significant side effects > generated by long-term oral use of marijuana or long-term inhalation of > marijuana smoke make marijuana a poor choice in the treatment of > glaucoma, a chronic disease requiring proven and effective treatment." > Sherry

I have read studys that indicate the lower your blood pressure the better.  I doubt very much that hypotension is a problem for the optic nerve. I also am not so sure that THC causes hypotension. I am wondering if there is anything further on the following: ". . . Because the possibility exists that marijuana (or its components) may be useful in treating glaucoma, the American Academy on Ophthalmology Committee on Drugs believes that a long term clinical study, designed to test the safety and efficacy of marijuana in the prevention of progressive optic nerve damage and consequent visual field loss, appears appropriate." I have also read the warnings for Xalatan which apparently is one of the safer drops to lower IOP. I do not understand why infection is an issue with this drug and seemingly all the others.  Infection does not appear to be an issue with contact lens solution. Or visine for that matter.

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"Mark Schmidt" <mark_schm…@hotmail.com> wrote in message

news:41c142b0$0$13948$afc38c87@news.optusnet.com.au… – Hide quoted text — Show quoted text -> Hi Tom > How can you seriously contemplate using an illicit drug, which has never had > any research attached to it, and is acknowledged as being harmful to your > general system, to address a local (eye) problem when you cannot measure the > effectiveness of the treatment, since no qualified practitioner would ever > agree to monitor your progress, as they would be implicated in an illegal > act and could jeopardise their Practicing License.  Please understand that > all drugs can have side-effects, which vary from person to person, but your > probability of successful, long term treatment on correct Doctor-prescribed > drugs is much higher than your probability of success using a > non-recognised, non-regulated and non-controlled course of action.  I don’t > know how old you are, but you must also consider the effect of using > marijuana for decades, and also consider that this course of action will > prevent you from ever boarding an international flight, as you will not be > able to take your stash with you. > I beg you to think carefully about this course of action. > Best wishes for Christmas > Mark > Optometrist > Sydney, Australia > "tom" <l…@home.com> wrote in message > news:F45wd.576635$D%.503257@attbi_s51… > > I have been studying the drug options for > > glaucoma.  I dont have any idea with regards to > > effectiveness, but there is no doubt in my mind > > anyway that marijuana is far and away the safest > > of all the alternatives. > > I am a bit scared of taking any of the other > > medications for any period of time.  They all > > seem to be very potent and dangerous drugs > > if they enter the bloodstream.

At this point I am not contemplating anything.  I am trying to gather information. I know for a fact that the risks of marijuana are overstated.  This drug has been around for thousands of years and noone ever has died from it.  All the other drugs that I have seen to treat IOP can kill you, and further if they dont kill you they can blind you. It is also bothersome that these drugs dont have the long track record that marijuana has.  For example, I was worried about viox when it first came out because it lacked history.  Aspirin is safer than all the newer drugs at least with respect to the fact that it has been around for so long.  Marijuana has a much longer history than aspirin. What I dont understand is why people that suffer from IOP are not putting some major heat on the powers that be for research on the benefits of marijuana with respect to IOP. I am also wondering if marijuana is effective against IOP if ingested instead of smoked.  If it is effective taken orally, this would be one huge point in its favor.

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"tom" <l…@home.com> wrote in news:JC5yd.270077$HA.56023@attbi_s01: <snip> > So is there any more danger of infection with glaucoma > eye drops than there is for soft contact lens rewetting > solution for example?  It seems from reading the > product information for these drugs that the bottle > is easily contaminated.

Product information from Drugs.com for Visine which can be found at (using TinyURL for the link) http://tinyurl.com/6ew85: "Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye." I have several bottles of different types of lubricating drops – they all warn about not touching the tip to anything to avoid contamination. Contact lenses, if not properly cared for, can cause serious eye infection.  I would think that anyone who has purchased contact lenses would be given the instructions for proper care at the time of first getting them.  At http://www.eyesearch.com/contact.lens.solutions.htm is instructions for the different types of lenses mentioning the need for disinfecting. Sherry

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"Laura" <mcki…@hotmail.com> wrote in message

news:ve6fs0djnf7jdrj4ltkcfd59lo042q9eos@4ax.com… > Seems to me infection is a possibility with * anything * you put in > your eye, simply because you’re putting something foreign into it. > Hence, wash your hands, don’t touch the bottle tip, etc. > Laura > On Tue, 21 Dec 2004 02:43:58 GMT, "tom" <l…@home.com> wrote: > >I have also read the warnings for Xalatan which > >apparently is one of the safer drops to lower IOP. > >I do not understand why infection is an issue with > >this drug and seemingly all the others.  Infection does > >not appear to be an issue with contact lens solution. > >Or visine for that matter.

So is there any more danger of infection with glaucoma eye drops than there is for soft contact lens rewetting solution for example?  It seems from reading the product information for these drugs that the bottle is easily contaminated.

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tom wrote: > I have been studying the drug options for > glaucoma.  I dont have any idea with regards to > effectiveness, but there is no doubt in my mind > anyway that marijuana is far and away the safest > of all the alternatives. > I am a bit scared of taking any of the other > medications for any period of time.  They all > seem to be very potent and dangerous drugs > if they enter the bloodstream.

Bad idea, I have heard that Marijuana is used as a painkiller for pain in chronic conditions like MS, Glaucoma etc. It’s not a treatment of Glaucoma itself and painful eyes are eyes that are self destructing … It’s a bit like having a broken leg and smoking for the pain. You’d still put the leg in plaster wouldn’t you?

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<eyegu…@aol.com> wrote in message

news:1103335401.798055.175620@z14g2000cwz.googlegroups.com… – Hide quoted text — Show quoted text -> While it is true that the harmful side effects of marijuana may be > overstated, it has not been found to be a useful IOP-lowering agent > because of its short duration of action.  In order to keep your IOP low > enough to protect your optic nerve, you would have to be stoned 24/7. > Hard to go around leading a productive life that way.  Also, last time > I checked it was…ILLEGAL!!! > While we’re talking about "overstating" and "not knowing what you > are talking about," lets address your comments about death and > blindness from glaucoma drops.  In my nine years as a glaucoma > specialist and twelve years treating eye diseases, I have only seen ONE > patient admitted to the hospital as a result of glaucoma treatment (an > asthmatic patient became short of breath on Betoptic S…he did fine > with oxygen, a nebulizer treatment, and discontinuation of the drops). > I have seen no deaths or blindness caused by these drops in over 10,000 > patients I have treated.  The worst ocular side effect I have seen from > these drops has been allergy or corneal irritation, which goes away > after you stop them.  Systemically, I have seen fatigue or depression > from Alphagan or Timoptic.  As for long track records, while these > drops haven’t been around for thousands of years, many have been around > for decades (Timoptic’s been around for over 30 years…that’s not > enough for you?).  Most of these drops, like Xalatan, for instance, > have been around almost 10 years and were in research for several years > before that.  Xalatan is safe and effective and is an excellent > medication…I’m certain it has prevented many of my patients from > losing sight to glaucoma. > I agree with others here that it sounds like you are just looking > for a way to get cheaper and legalized recreational pot…don’t waste > our time promoting it as a useful glaucoma therapy. > –Rick Cohn, MD > Glaucoma Specialist > Winter Park, FL

Product information about Xalatan: http://www.pfizer.com/download/uspi_xalatan.pdf This does not strike me as exactly safe, and this is the research from Pfizer and we can see with Celebrax that we cannot be completely confident in that which a drug company says about their product when they are making so much money from their product. I am also disturbed that you are impugning my motives here.  This suggests that you have an agenda.  I do have an agenda, which is to find out as much as possible about all possible treatments to reduce IOP.  Apparently your agenda is exactly the opposite.

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Seems to me infection is a possibility with * anything * you put in your eye, simply because you’re putting something foreign into it. Hence, wash your hands, don’t touch the bottle tip, etc. Laura – Hide quoted text — Show quoted text -On Tue, 21 Dec 2004 02:43:58 GMT, "tom" <l…@home.com> wrote: >I have also read the warnings for Xalatan which >apparently is one of the safer drops to lower IOP. >I do not understand why infection is an issue with >this drug and seemingly all the others.  Infection does >not appear to be an issue with contact lens solution. >Or visine for that matter.

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"Looker" <loo…@firstpobox.com> wrote in message

news:926da283.0412190859.5113c11b@posting.google.com… > Tom, > I did not read any opposite agenda in Dr. Cohn message. Instead, I > always have seen him, for a long time, trying to help us, glaucoma > sufferers, explaining and clarifying many aspects of the disease. > Small pupil ( a glaucoma sufferer)

If my response was rude, I apologize. Dr. Cohn wrote the following: "While it is true that the harmful side effects of marijuana may be overstated, it has not been found to be a useful IOP-lowering agent because of its short duration of action.  In order to keep your IOP low enough to protect your optic nerve, you would have to be stoned 24/7." I would be grateful if Dr. Cohn posted the details of any scientific studies which lead to this conclusion.

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Well you know the answer Tom; get stoned, stay stoned and let us know how you got on 10 years from now. In the meantime, I’ll stick to prescribed medication which has prevented deterioration of my sight for the past five years. Checkout.

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It’s been a long time. My pupils were dilated and the back of my eyes examined. I don’t recall certainty of damage, only that the pressure would eventually cause damage. This doc bought my previous doc’s practice. That was my first and last visit.

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In the early 90s an opthomologist diagnosed glaucoma (left IOP of 26) and told me I could be blind in 8 years. I was given samples of a drug (name unremembered) which I was supposed to put in my eyes for the rest of my life. Given the warnings about possible heart muscle deterioration and the understanding I would develop a tolerance to the drug that would gradually reduce effectiveness, I decided to not to take it. Though the doc told me eye exercises were futile, I resumed doing them (had been doing them previously but had stopped). At the same time, my time in front of a CRT probably lessened as well. Approx 8 years later and experiencing no loss of peripheral vision, I got an eye exam from an optomotrist. Eye pressure normal, no glaucoma. More than 10 years now and no noticeable vision loss. Suggest anyone getting diagnosed with glaucoma wait a few weeks and get a second opinion before dedicating themselves to dubious medication for the rest of their lives. nf

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Personally I think if there is any question, a second opinion is always a good idea–from a glaucoma specialist. One high IOP reading does not mean glaucoma.  In fact, high eye pressures do not in themselves mean a person has or will develop glaucoma. Did the ophthalmalogist exam your optic nerves? -Gudrun

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Thanks for the reply. I have now replaced Cosopt by just the Trusopt component, thus eliminating the beta-blocker (timolol). I am wondering how one measures the timolol residue in the body as alluded to in your post.Heart rate this AM was 54 instead of the previous 45-46, but we’ll see. Now, of course, I will wait and see if my pressure elevates significantly (you didn’t address that aspect in your examples). I am currently on alphagan (twice/day), xalatan (once/day) and formerly cosopt, now trusopt (twice/day). Use pilocarpine in the  right eye only at bedtime. Have had SLT (180 degree arc in both eyes). Pressure has varied from 18 to 25, depending on time of day, etc. HRT showed no significant loss in either eye….BT

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Any words of wisdom on blockers as a possible cause Bradycardia? I have been using drops for 34 years for Primary Open-Angle Glaucoma, including timolol (alone and in cosopt). My heart rate has been gradually slowing up over the years and is presently as low as 45 beats per minute resting (and I am no super athelete). I am now 64. Recent searches on the internet reveal a possible connection. Specific cases are cited: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume… Now, no ophthalmologists ever seem to inquire about non-obvious side effects, but I myself am now wondering. Any thoughts from those in the know? Benjamin Trimble

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btrim…@yahoo.com wrote: > Any words of wisdom on blockers as a possible cause Bradycardia? I have > been using drops for 34 years for Primary Open-Angle Glaucoma, > including timolol (alone and in cosopt). My heart rate has been > gradually slowing up over the years and is presently as low as 45 beats > per minute resting (and I am no super athelete). I am now 64. Recent > searches on the internet reveal a possible connection. Specific cases > are cited:

http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume… > Now, no ophthalmologists ever seem to inquire about non-obvious side > effects, but I myself am now wondering. > Any thoughts from those in the know? > Benjamin Trimble

Bradycardia is certainly a possible side effect of ocular beta blocker drops.  I have had to discontinue Timoptic in a few patients over the years for just this reason.  This was usually at the request of their cardiologist.  In each case (I think there were only two), the heart rate did not climb significantly once I washed the Timoptic out of the patient’s system (this can take 4 – 6 weeks).  Both patients eventually needed pacemakers placed, and both did just fine.  Ask your ophthalmologist if there is something else you can take in place of the beta blocker, and see if your heart rate goes up.  Good luck to you…let us know what happens. –Rick Cohn, MD Glaucoma Specialist Winter Park, FL

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