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Reasonable expectation for Glaucoma progression?
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Reasonable expectation for Glaucoma progression?

If Glaucoma is caught very early, and the pressure (before treatment) is 18-19, is hoping for it to progress so slowly as to not lose visual function an unreasonable expectation?

The specifics are: 42 year old male, IOP (both eyes) 18-19 (treatment with Xalatan just begun).  No field loss in left eye, very minor field loss in right eye.  Strangely, visual examination of the optic nerve showed nothing to the specialist that suggested nerve damage -- the only way he could even confirm that it was was from an OCT measurement showing the right eye nerve being slightly thinner than the left (85 microns avergage left, 80 microns average right).

So is it unreasonable to hope that Xalatan could slow this down either completely or to such a slow pace as to not impair function over the next (hopefully) 40 years!!

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Any possibility that an episode of CSR (in right eye) could somehow be responsible for nerve damage in the right eye (i.e. another hope that this won't be progressive).

Tags: glaucoma, CSR
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Most severe vision loss is due to the diagnosis and treatment not being made until after extensive damage is done. (one of the main reasons to have yearly medical eye exams by an Eye MD). Second biggest cause is poor patient compliaance. There is a distressingly high number of people that stop their medicine, stop seeing an opthalmologist or do not use their medicine as prescribed or run out of meds regularily.

There is however the worse 3-5% of glaucoma cases that progress in spite if vigorous treatment (up to 4 different drops 5-8 times/day, selective laser trabeculoplasty and filtering surgery).  One reason is that current research indicates that some damage that progresses is NOT due to pressure and we do not understand how this occurs and how to prevent it.

The odds are heavaily on your side that if you are compliant that your vision will last a lifetime.  New drugs from the much (unfairly) criticized pharmaceutical industry are on the horizon.

JCH II MD
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Thanks.  Despite a wealth of information from Google, it's been hard to find even that much concerning what a reasonable hope is.  (I was diagnosed on Tuesday, and I'm only starting to calm down slightly.)

I'm a bit puzzled my Dr. (a Glaucoma specialist) didn't volunteer what you just relayed.  On the other hand, he was willing to wait 2-3 months to start eye drops if I wanted, and do another visual field/OCT first.  I guess he knows that this early on 2-3 months isn't long enough to make a long-term difference, so perhaps he doesn't quite get/has forgotten after some number of years how scary this seems.  (If I was 70, I wouldn't be so worried, since the progression is slow.)  At 40, I need to last another good 30-40 years though...

Thanks again for the info.  This bboard is a wonderful service.

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