Glaucoma Pressure Question

[robpom]

I have been told that my doctor suspects I have glaucoma and is keeping a watch on it.

My question is, if I do have it, what is the pressure number that my eye pressure should be under?  It is currently 15 in one eye and 16 in the other.  The nurse said that was ok, but I read somewhere that if you have glaucoma, it should be under 12 to prevent the effects of blindness,etc.

[russell903]

I was diagnosed with glaucoma in one eye 2-3/4 years ago.  At the time, my eye pressure was at 30.  Change in pressure was abrupt; w/in 6 months it went to 30 from 16.  At that time,the eye MD said he wanted it below 25 for safety and to control the disease.  Then he determined from observation and other tests that the 25 figure was not controlling my condition and targeted the teens for a figure.  I have since had two eye operations (laser and filtration) and now am at 10-12.  Present thinking appears to be that most eye MD's target eye pressure as low as they possibly can go short of extreme low pressures which can affect shape of eyeball.  If I were you, I would have the pressures monitored as often as possible, and not just at 1 year or 6 month intervals.  Even if your insurance does not pay for more frequent testing, pay for it yourself.  There is no greater sense that we have than that of sight.  Best wishes to you.  Russell903  

[russell903]

One question-were the eye pressures taken with an air burst test?  Or with a machine that has a blue circle which contacts your eye?  The air burst test is old technology and less accurate, according to eye MD's I've seen.  the blue circle machine is sometimes described as a Goldman Tonometer.  Russell903

[AnnaE]

Dr. Hagan also says the Golman is the best, the "standard."

[russell903]

Now if there only was a 'standard' to replace in my opinion, the worst diagnostic device in ophthalmology, the visual field test.  That is one of the least accurate measurement tools I've experienced in my visual problems monitoring.  Patients don't like it, and the doctors don't appear to have a clear indicator of what the patterns mean relative to eye problems.  Nor do two doctors typically agree on a diagnosis of visual field tests, on patients with complicated eye problems, from my experience.  EG, If a patient, like me, has lots of floaters, throw the test out.  Russell903  

[John C Hagan III, MD, FACS]

Glaucoma is a very complex disease and in some people damange may not occure with an average IOP of 30 and in another damage may occur with an average IOP of 17.  Also the IOP varies from hour to hour. So if it was 15 and 16 in your eye MD s office it does'nt mean it was the same at 9 PM or 3 AM.

frequent exams with IOP, eval of visual fields, optic nerve topography, OCT of eye, etc must be done to determine if the glaucoma is controlled.

JCH MD

[robpom]

When you say "frequent" exams - how much is that?

[John C Hagan III, MD, FACS]

My best glaucoma patients (easily controled, stable fields and optic nerves and reliable in meds/appointments) I see twice per year.  Most patients I see three times per year. My worst glaucoma patients I may see very 2 months.

JHC MD