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Need help understanding eye issues

by edanz, May 22, 2008 11:10PM
Here's my situation (male, early 30s, no family history of glaucoma):

Both eyes
1. Seem to have baseline IOP of 21, which was up at 29 for a week following use of steroids
2. Peripheral vision seems just fine to me, but computer perimetry today showed I have very limited ability to perceive light flashes outside my central field of vision
3. Feel as though there's a very subtle black overlay to my visual field.  Actually, it's not even an overlay, more like a quiet note in a musical chord, as though I see the world and the black simultaneously, but mostly see the world.
4. Both eyes look absolutely normal to ophthalmologists, no evidence of retinal or other damage (but I do have giant papillary conjunctivitis from contact lens wear)

Left eye
1. More myopic
2. Had severe stabbing pain for 2 days
3. More affected by (3) above
4. Occasionally see "floaters"

My ophthalmologist seems very competent, but very busy.  Interactions are very short.  I don't understand what's going on really.  Any advice on reading material to inform me?  Anything I should be asking him?

Thank you.  And thanks to Dr. Hagan for providing some great answers previously.
Member Comments (2)

by John C Hagan III, MD, FACS, May 22, 2008 11:54PM
1. You're a glaucoma suspect and should have a glaucoma work up: visual fields, optic nerve photos, optic nerve OCT, central corneal thickness measurements, gonioscopy and follow up with an ophthalmologist twice/year.

2. Your visual abnormalities may quitelikely be due to your contacts and GPC. Actually with GPC you should probably NOT wear your contacts, use cromolyn drops and give your eye several months rest until the GPC goes away.  After than you might consider daily disposable contacts, glasses or lasik.

GPC produces mucous that coats the cornea and fills the tear film.

JCH III MD

by nangi, Aug 25, 2008 02:18PM
To: Dr. John C Hagan MD FACS
I have been diagnosed as having as low tension Glaucoma. I am a 51 year old Doctor. I have visual field defect in my left eye in the upper half, and also in the right eye. I have transient  blurring of vision for nearly nine years and I have sever headaches for the last thirty years which I presume as been migraine. The scotoma bothers as when I close my right eye I see a black line going right through the upper half above and below I can see. When I look at my face in the mirror with my right eye closed and focus on my chin I see a decapitated figure. When I read with my right eye closed I see only the line I am focussing on above this is black.but again I can see some light at the top of the page. Doctors say my right eye has been damaged by low tension glaucoma and my left eye is damaged by Retinal migraine and Glaucoma. I am on Topiromate. Azopt and Lumigan Asprin. my eye condition was diagnosed only last January. By that time I had the scotoma. Please advse as to how I can stop the progress of this disease. and what is the best centre . I live in SriLanka. Thank You.

by John C Hagan III, MD, FACS, Aug 25, 2008 03:20PM
From your history it is likely that your vision is damaged (glaucoma scotoma). That being the case not much can be done to improved the damage and efforts need to be made to keep it from getting worse.

you need to be under the care of an Eye MD ophthalmologist experienced in treating glaucoma and see him/her at least 3 times/year.

You need to put you drops in each and every day and not run out of your medications for glaucoma.

JCH MD

by dissana, Aug 13, 2009 12:47PM
To: nangi
Hi

Have you ever had a CT brain..................to exclude the mass effect for visual field defects(In fact asymmetrical.)

by John C Hagan III, MD, FACS, Aug 13, 2009 01:51PM
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