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Help–What's causing light sensitivity?

Question:

Marthae responded to my message concerning her father’s sensitivity to light, >I can check this.  What would it tell me? >I’m guessing that if his pupils were dilated and didn’t constrict in response >to a bright light, it would probably be drop-related.  I’m not sure what >other >combinations (constricted versus dilated versus normal, and responsive versus >unresponsive) would mean, though.  <

I am not a professional, so my answer can only be considered a layman’s view. Some eye drops tightly constrict the pupil. A very small pupil would not appear to accompany sensitivity to light. Other medications cause dilation of the pupil, and failure to constrict in presence of brighter light (as the eye is constructed to do) would make sensitivity to light very likely. Different people react to medications in different ways and to different degrees; there are some medications that just don’t work out well with certain people, and don’t provide the desired results. Conditions other than medication can cause dilation/constriction and different reactions in one eye than another and if not attributable to eyedrops may suggest the need for investigation by an internist at the least. Cataracts can also cause light problems, and in the event of even a slightly constricted pupil, under some circumstances, may force vision to come through a narrower, more restricted area of the lens. If the pupil size is normal, and reaction to changes in light is normal, it may imply another type of side effect from medication, or another source, is involved.

Response:

- Hide quoted text — Show quoted text -mart…@aol.com (MarthaE) wrote: >I’m hoping someone reading this can help me . . . >My father (who’s 77) was diagnosed with glaucoma last summer.  When he first >visited the opthamologist, he didn’t have any problems with his eyes.  He had >gone in for a routine eye exam to get glasses, and they gave him drops for >glaucoma. >Ever since then, he has had *horrible* problems with light sensitivity.  He has >to wear dark sunglasses all the time, and still complains about the light. >(When I visited him yesterday, he was wearing sunglasses in the house, and it >was a cloudy day!  He said that the light was *still* hurting his eyes, even >with the sunglasses on.) >He has been back to the eye doctor five times for this, and they have changed >his eye drops twice.  They keep telling him that everything’s just fine, and >that he should keep using the drops.  This morning, they told him that "maybe >the light sensitivity will improve with time" but didn’t tell him what was >causing it in the first place.  They said his eyes were "looking good" and that >everything was fine.  Needless to say, I’m concerned. >Does anyone know if horrible problems with light sensitivity are a side effect >of glaucoma, or of the drops normally given for glaucoma?  Has anyone here had >problems like that? >Thanks in advance for any advice you can give me about this!

What was the indication that your father either had glaucoma (actual nerve damage or loss of sight) or might soon get it?  Or did the MDs claim his intraocular pressure was high?  Or did they give any other reason to start the drops?  Where were the successive kinds of drops given? Whatever, I would have him stop all drops for a couple of months. Then, whether or not his eye sensitivity clears up, he could have his eyes checked out again from a totally new start — without mentioning the previous involvement with eye treatment to the new MD, or having any records sent to him — until a new, completely independent, diagnosis is given.  What went on previously could then be mentioned in that context.  If there’s any tendency at that point for the second MD to modify his independent view, I’d go to a third MD — or forget the matter if the second diagnosis was essentially negative. Ray (not any kind of eye-care professional)

Response:

I’m hoping someone reading this can help me . . . My father (who’s 77) was diagnosed with glaucoma last summer.  When he first visited the opthamologist, he didn’t have any problems with his eyes.  He had gone in for a routine eye exam to get glasses, and they gave him drops for glaucoma. Ever since then, he has had *horrible* problems with light sensitivity.  He has to wear dark sunglasses all the time, and still complains about the light. (When I visited him yesterday, he was wearing sunglasses in the house, and it was a cloudy day!  He said that the light was *still* hurting his eyes, even with the sunglasses on.) He has been back to the eye doctor five times for this, and they have changed his eye drops twice.  They keep telling him that everything’s just fine, and that he should keep using the drops.  This morning, they told him that "maybe the light sensitivity will improve with time" but didn’t tell him what was causing it in the first place.  They said his eyes were "looking good" and that everything was fine.  Needless to say, I’m concerned. Does anyone know if horrible problems with light sensitivity are a side effect of glaucoma, or of the drops normally given for glaucoma?  Has anyone here had problems like that? Thanks in advance for any advice you can give me about this!

Response:

As it turns out, he was referred to the opthamologist by an optometrist who diagnosed the beginnings of cataracts, not glaucoma.  (In fact, the optometrist later told us that Dad did not have any sign of glaucoma when he saw him last spring.)  The opthamologist said he didn’t have cataracts, but that he had the beginnings of glaucoma.  The opthamologist had him come back again and again to run a bunch of fancy tests, but didn’t explain what he was doing or why.  (Mom and Dad didn’t ask, either.  Until now, they have never really questioned what their doctors have done, or why.  They’re more comfortable assuming that a doctor is right.)  Now, whenever Dad goes back to complain about the light sensitivity, they just run another test or two and tell him he’s doing fine. They have changed the type of drops twice, but now seem reluctant to do anything more. Dad hadn’t had *any* light sensitivity until he started the drops.  Almost immediately after starting the drops, he had to start wearing clip-on sunglasses whenever he went anywhere, and things have gone from bad to worse. Now, he’s wearing dark sunglasses indoors and complaining of the light.  He can’t sit indoors in a moderately-lit room without having to close his eyes. Needless to say, this is affecting his life. Whenever he asks the opthamologist about stopping the drops for a couple of weeks to see if they’re the problem, the opthamologist says that he can’t stop the drops or he may go blind from glaucoma.  This has scared Dad into continuing the drops.  (I like the suggestion from Raymond Chamberlin that Dad discontinue the drops and start anew with a second doctor to see if he diagnoses glaucoma.  Unfortunately, I don’t think Dad would want to stop the drops until he’s told that it’s okay.) I encouraged them to seek a second opinion, so they have an appointment with another eye doctor in a little over a month (as soon as they could get one). I’ll let you all know what we learn.

Response:

Hi Martha; Dr. Robert Ritch responds that we see light sensitivity very often, but usually after surgery. It can also occur in patients with cataracts. When it happens from drops, it goes away when the drops are stopped. If it’s not going away here, then Dr. Ritch suggests that your father have a second opinion from a glaucoma specialist. – Hide quoted text — Show quoted text -mart…@aol.com (MarthaE) wrote: >I’m hoping someone reading this can help me . . . >My father (who’s 77) was diagnosed with glaucoma last summer.  When he first >visited the opthamologist, he didn’t have any problems with his eyes.  He had >gone in for a routine eye exam to get glasses, and they gave him drops for >glaucoma. >Ever since then, he has had *horrible* problems with light sensitivity.  He has >to wear dark sunglasses all the time, and still complains about the light. >(When I visited him yesterday, he was wearing sunglasses in the house, and it >was a cloudy day!  He said that the light was *still* hurting his eyes, even >with the sunglasses on.) >He has been back to the eye doctor five times for this, and they have changed >his eye drops twice.  They keep telling him that everything’s just fine, and >that he should keep using the drops.  This morning, they told him that "maybe >the light sensitivity will improve with time" but didn’t tell him what was >causing it in the first place.  They said his eyes were "looking good" and that >everything was fine.  Needless to say, I’m concerned. >Does anyone know if horrible problems with light sensitivity are a side effect >of glaucoma, or of the drops normally given for glaucoma?  Has anyone here had >problems like that? >Thanks in advance for any advice you can give me about this!

Response:

On 10 Dec 1997 14:15:18 GMT, mart…@aol.com (MarthaE) wrote: …………. >Whenever he asks the opthamologist about stopping the drops for a couple of >weeks to see if they’re the problem, the opthamologist says that he can’t stop >the drops or he may go blind from glaucoma.  This has scared Dad into >continuing the drops.  (I like the suggestion from Raymond Chamberlin that Dad >discontinue the drops and start anew with a second doctor to see if he >diagnoses glaucoma.  Unfortunately, I don’t think Dad would want to stop the >drops until he’s told that it’s okay.) >I encouraged them to seek a second opinion, so they have an appointment with >another eye doctor in a little over a month (as soon as they could get one). >I’ll let you all know what we learn.

Have your father read my Web page at:         http://www.geocities.com/CapitolHill/1284/glaucoma.html and maybe come of the one at:         http://www.geocities.com/CapitolHill/1284/introdef.html The references listed on the first page are essentially all from *peer-reviewed clinical* journals.  Many of the authors are MDs and the rest PhDs in eye fields.  Let your father realize some of what has gone on and still goes on in the glaucoma field.  Let him realize that he should not get hung up on what one or even several MDs have to say about his condition.  The field is intense ego and money nearly throughout.  After reading that (or having it read to him), I then still put forth the recommendations of my earlier post: >Whatever, I would have him stop all drops for a couple of months. >Then, whether or not his eye sensitivity clears up, he could have his >eyes checked out again from a totally new start — without mentioning >the previous involvement with eye treatment to the new MD, or having >any records sent to him — until a new, completely independent, >diagnosis is given.  What went on previously could then be mentioned >in that context.  If there’s any tendency at that point for the second >MD to modify his independent view, I’d go to a third MD — or forget >the matter if the second diagnosis was essentially negative.

DON’T GIVE A NEW MD ANY PAST DIAGNOSTIC OR TREATMENT INFO UNTIL (S)HE DIAGNOSES *WITH A RATIONALE THEREFOR*, AND IT IS BETTER NOT TO HAVE BEEN ON ANY MEDICATION FOR SOME TIME PREVIOUSLY, SO THAT SUCH A FACTOR IS MINIMIZED AS TO A PRESENT DIAGNOSIS.  Some reconciliation of a new diagnosis, AFTER IT IS GIVEN, with your known past symptoms and treatment may later be in order, but GIVE ONLY THE MINIMAL AMOUNT OF INFO PREVIOUS TO ANY NEW DIAGNOSIS, in order to keep medical escalation from getting way off the track.  It is not that MDs, in the main, are necessarily out to rip people off; it is that they are typically creatures of habit and rote learning and are very true to their Hippocratic guild/gang and its other members.  Most are not all that sharp and observant. Ray (not any kind of eye-care professional)

Response:

A brief reply to marthae who wrote concerning her father’s sensitivity to light. I assume someone has thought to look at his pupils. Are they dilated or constricted? Do they respond to a bright light coming near them? This would tell you a great deal. (Not a professional message)

Response:

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