Cataracts with angle clousure glaucoma

On a recent visit to a glaucome specialist, I was diagonsed with 3+ nuclear and 1+ cortical cataract in right eye, 4+ nuclear and 1+ cortical in the left eye. My visual acuity was 20/20 in right eye and 20/100 in the left. I can't read the largest letter on the chart.....Why is there such a difference in my vision when the cataract numbers are so close? I also have a 20+ year history of angle closure glaucoma....with 3 iridotomies in the left eye and 2 procedures in the right. Occasionally, I have pressure spikes and was recently diagnosed with plateau iris syndrome. I an scheduled this week for iridoplasty. Could the difference in vision be damage from the years of pressure spikes? Or is it cataracts? At what point will I need cataract surgery?

[Michael J Kutryb, MD]

The worse vision in the left eye could be due to:  a cloudier cataract, optic nerve damage from glaucoma, macular degeneration, epiretinal membrane, corneal disease, and other causes.  Hopefully, the cause is just a cloudier cataract, because that can be corrected with surgery.  It sounds like you have an excellent glaucoma specialist.  One way to determine if the blurry vision could be corrected with cataract surgery is a PAM potential acuity test - which can give a rough estimate of what you visual acuity could possibly be after cataract surgery.

Finally, don't get too caught up in the numbers 3+, 4+  etc.  Put very simply, the cataract is much cloudier in the left eye.  If it's a 4+ cataract - that's about as dense at they get - so it sounds like you may need cataract surgery sometime soon.  
MJK MD

[Onnieellen]

The last several days I've had this unusual feeling on the left side of my face......It feels a little numb with slight pins and needles, like a foot going to sleep. Sometimes, using pilocarpine relieves the feeling. Can this have anything to do with my glaucoma or other eye problems? I'm scheduled for iridoplasty tomorrow. (by out of town glaucoma specialist)...should I mention feeling to my doctor? Or do you think  it could be stress? I've read alot about iridoplasty and question it's need and success rate.  I have pressure attacks occassionally, usually when I'm really stressed or tired (hours on the computer).....or after 3-4 hours of sewing projects, wall painting, stripping wall paper, etc