1 Update on Prostaglandin Analogues Used for the Treatment of Glaucoma.
Your Questions About Glaucoma Treatment
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William asks… What are the risks of having a cataract operation done? I have bad eyesight from my younger days. Recently I have been diagnosed with Glaucoma (responding to treatment). Dr. says getting a cataract operation will improve my sight. I do not have any cataracts in my eyes. I am 45 years old, female. I have Type 2 Diabetes (though taking Insulin) but no retinopathy. I am short sighted as well as have astigmatism. Is it true that getting a cataract done - replacing lenses has some risks and the operation can go wrong? admin answers: Risks of cataract surgery As in any surgical procedure, a small element of risk exists. Occasional unavoidable complications may occur during surgery such as infection, retinal detachment, macular swelling, hemorrhage, etc. While these complications are extremely rare, they may occur. In some cases, vision does not improve because of a preexisting condition such as macular degeneration, glaucoma or other diseases of the optic nerve and retina. It is impossible to predict in which patients these complications will occur. In some cases, there is a possibility that your vision may not improve as much as you would have liked. A very rare complication is the possibility that the intraocular lens will require removal or repositioning. No operation of any sort can ever be performed without risk. However, 95% of all patients having cataract surgery will see significantly better without complication. If patients with abnormal retinas are excluded from this group, the success rate becomes even higher. 1 / 6
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Transcript of Your Questions About Glaucoma Treatment
William asks…
What are the risks of having a cataract operation done?
I have bad eyesight from my younger days. Recently I have been diagnosed with Glaucoma(responding to treatment). Dr. says getting a cataract operation will improve my sight. I do nothave any cataracts in my eyes. I am 45 years old, female. I have Type 2 Diabetes (thoughtaking Insulin) but no retinopathy. I am short sighted as well as have astigmatism. Is it true thatgetting a cataract done - replacing lenses has some risks and the operation can go wrong?
admin answers:
Risks of cataract surgeryAs in any surgical procedure, a small element of risk exists. Occasional unavoidablecomplications may occur during surgery such as infection, retinal detachment, macular swelling,hemorrhage, etc. While these complications are extremely rare, they may occur. In some cases,vision does not improve because of a preexisting condition such as macular degeneration,glaucoma or other diseases of the optic nerve and retina. It is impossible to predict in whichpatients these complications will occur.
In some cases, there is a possibility that your vision may not improve as much as you wouldhave liked. A very rare complication is the possibility that the intraocular lens will requireremoval or repositioning. No operation of any sort can ever be performed without risk. However,95% of all patients having cataract surgery will see significantly better without complication. Ifpatients with abnormal retinas are excluded from this group, the success rate becomes evenhigher.
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Richard asks…
What are the best proven over the counter products for the treatment of cataracts?
I've come across a product called Brite Eyes III, which supposedly is helpful for cataracts andglaucoma support, but have not found enough information or reviews about the product to makea decision about buying it for my stepdad.Products that can temporarily relieve symptoms of cataracts.
admin answers:
None, cataracts are treated with surgery
George asks…
Any tips on getting my Grandma with Alzheimer's to get through a laser eye Glaucomatreatment?
She cannot be chemically sedated during these procedures. She is going blind and when I tried
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to take her for the procedure previously she flipped out and flailed and screamed until we tookher home. She is going blind and needs this procedure. Any tips and or personal stories wouldbe much appreciated!
admin answers:
I would first talk with her Primary Care Doctor and see if they have any suggestions.
John asks…
What is building up of fluid in the front side of the eye mean?
My doctor has advised me to have a laser treatment in the eye to open the part where the fluidis bulding up. Has anyone undergone this type of treatment. Let me know your experience andany tips.
admin answers:
There are a number of treatments for glaucoma. Glaucoma is a condition where the nerve at theback of the eye, the optic nerve...becomes damaged somehow related to pressure. Thisdamage eventually goes back to the retinal ganglion cells which die....don't see no more....
In order for the eyeball to stay "firm", it produces aqueous. This is produced by the ciliaryepithelium by passive (sort of a filter) and active (requires energy and gland like production offluid) means.
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If the eye puts....let's say 5 drops of fluid into the eye a day, it'll drain 5 drops a day. If the draingets a little stopped up for whatever reason...blood cells clogging it up=hemorrhagic glaucoma,white cells clogging it up=leukemic glaucoma or lymphoma, pigment cells clogging itup=pigmentary glaucoma, exfoliation of the lens capsule=exfoliation glaucoma....whatever the reason...And the drain is clogged, it drains slower...the guys making the fluid don't know. They keep oncranking out that 5 drops a day. The pressure goes up till the fluid is forced out at 5 drops a day.If that pressure is too high for the nerve...and the nerve fibers become damaged and theganglion cells are damaged and vision is lost...that's glaucoma.
The treatment is to either increase the drainage rate OR decrease the production rate. That's IT.
So we give people drops to do one of those or a combination of those two things...increase thedrain or slow the production of aqueous.
The laser treatments vary. The old trabeculoplasty was done around the drain every fewdegrees so that little scars were formed. These scars pulled on the meshwork between them,pulling open the meshwork in that area. Works for awhile, but it closes up again sooner or later.There are also laser Rx that puts little holes in the trabecular meshwork...hurts a bit, doesn'twork all that well, but a good idea.
The newest, latest, most coolest glaucoma surgery is done where a small canula is inserted intoSchlemm's canal and a large portion of the meshwork is opened into the anterior chamber. Thisjust works nicely with a large percentage of eyes not requiring any medication and pressuresmaintained in the low teens.
Just as a precaution,...there are glaucoma specialists. If it were my eye, I'd see a glaucomaspecialist not only for a second opinion, but possibly for the treatment itself. It's not that mostgeneral ophthalmologists don't know how to do this, they do. Some just love glaucoma. Somearen't all that fond of it. But the glaucoma guy...that's sort of all he does. Smart decision totravel. Don't not bother. Glaucoma treatments can become nightmare not only for you, for thedoc as well.
Have you ever seen how an advanced glaucoma person walks? Shuffle, shuffle, shuffle.
See the glaucoma guy.
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Steven asks…
What is astigmatism, has it anything to do with glaucoma?
I want contact lenses and I thought the optician said my eyes were rhetoric, could he have beensaying "Toric". I was advised to choose the most expensive daily throw away kind, as I just wantto wear them a couple of times a week. I have glaucoma but got permission to wear contactlenses from my eye specialist.
admin answers:
The answer by danish was beautifully written but was so GENERAL it could define most visualdefects. Wikipedia has a good page explaining it:
http://en.wikipedia.org/wiki/Astigmatism?wasRedirected=true
If you google astigmatism there are plenty of user friendly sites that give good explanations. Butif I were to try and give a simple description I would say astigmatism refers to having lightentering the eye coming to focal points at different distances from the retina. Perfect visionrequires ALL light entering the eye to come to a focal point EXACTLY where the retina is.
The most common form of astigmatism is caused by irregularities in the curvature of the cornea.You can't actually see a persons astigmatic cornea if you wanted to because its actuallytransparent (invisible)This link below allows you to see what is the physical difference between an astigmatic eye anda normal one. These photos of cornea taken by specialists. It uses colors as a guide tosmoothness. Green is normal/regular, blue and red colours however indicate abnormalsteepness or flatness in curvature. (i checked the pics myself. They are mainly extremeexamples)
http://www.google.com/search?site=images&source=mog&gl=us&q=corneal%20topography
Astigmatism is very common and effects a lot of people without them even knowing it. Onecause discovered is from the pressure placed on the cornea by the eyelids while a personengages in activity such as reading.Due to the fixed position of the eye and the infrequent blinking scientists found that depressions
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can form the surface of the cornea after a long enough period of pressure from the eyelid. Theynoted though that these depressions usually disappear once the person rests their eyes later.
It's also possible for people to be born with astigmatism. The cause of this is often people beingborn with oval shaped eyeballs. This is hereditary.
A type of astigmatism with a completely different origin is one caused by irregularities in thecrystalline lens (inside the eye) People with diabetes often develop this issue from havingchanges in blood sugar levels. Treatment of diabetes often brings the effected persons visionback to normal.
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