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Low/normal tension Glaucoma question on progression
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Low/normal tension Glaucoma question on progression

I was recently diagnosed with low/normal tension Glaucoma.  I'm under 40.  I have 70-80% cupping in my eyes.  It's worse on the left eye.

Lt eye test showed peripheral vision loss with nerve damage in the area that correspondended to the area of peripheral vision loss).

They have not started me on treatment because my pressures were low.  Pressures were never above 15 on multiple test and has been tested as low as 10.  (puff test and the test where they put the flourescent drops in your eye - not sure what that's called).  I actually have to go back for ALL day testing to get an average of my eye pressures.  (goody!)

At any rate, my question is this:

I'm under 40 with evidence of obvious optic nerve damage and loss of peripheral vision.  I know Glaucoma is "supposed" to progress slowly but with my current level of damage, what will progression look like?  Will I progress faster?  How quickly does Glaucoma deteriorate the optic nerve?  I can't find answers on a "timeline", if you will, of progression.

Any thoughts?

BTW - I do have MS and have had 1 -2 courses of steroids per year for the past 10 years - 3 day infusions of 1000mg solumedrol.  Never an episode of Optic Neuritis.  Opthamologist said any increase in IO pressure during/after the steroids probably wouldn't have been sufficient to cause the damage I have....
Progression with glaucoma is very variable, and cannot be predicted for sure.  However, you are very young, and have a long life span, so you must be controlled at a consistently low eye pressure.  This means faithfully taking the drops every day and following up with your ophthalmologist on a regular basis.  I would also see a glaucoma specialist.  You need a pachymetry (measurement of your corneal thickness), as well as intraocular pressure measurements and visual fields.  Optic nerve imaging such as OCT can be helpful for following your status.  Your eye pressure needs to be lowered by at least 30% from baseline to protect the optic nerves from further damage, based on a national study of normal pressure glaucoma.
Thank you for answering!

I see a glaucoma specialist and have had all tests done.  Pics.  Visual field.  Pachymetry. That's how they determined nerve damage and loss of peripheral vision.  

He said they would have to treat me aggressively since I already have low pressures.

So, even with treatment, does glaucoma progress still?
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John C Hagan III, MD, FACS, FAAOBlank
Discover Vision Centers of Kansas City
Kansas City, MO
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