Young with glaucoma?

[NicoNicola]

Hi everyone. I am 19 years old, almost 20. Recently I attended my eye doctor and they said my eye pressure was high; I am not sure of the numbers. After my eye dilation my doctor said my cups were different sizes? I'm not totally sure what that means but I am being referred for a field test. I guess I just want to know about living with glaucoma. Does it mean you will go blind anyway? My vision now is normal I believe; my prescription glasses aren't even strong. I do have high blood pressure but am otherwise healthy. I'm just anxious and honestly a bit angry because I always thought this was an older person's disease and I don't want it to hinder my life at all. My grandfather had glaucoma but he was well into his seventies. I am only 19. Don't mean to wallow it's just I'm not sure of how I'm feeling or how to cope.

[JohnHaganMD]

I'm going to follow this post with a previous one about glaucoma but first I want to address you situation. It is far more likely you DON"T have glaucoma than you do have it. MOST IMPORTANT:  be sure the 'eye doctor' you saw was an Eye MD ophthalmologist. They have the best training and skill to make the diagnosis. If you saw a non-MD non-physician optometrist then go to see an Eye MD.  You can ask your family MD for a referral.   Okay so the follow is some general information about glaucoma but the very high odds are you do not have it. SEE AN EYE MD OPHTHALMOLOGIST.

reprint previous answer:

glaucoma is an extraordinarily complex disease. It's actually a whole group of diseases-depending on how you want to classify them there may be as many as 10-20 types. When the word "glaucoma' is used and not further qualified, what is meant is "Primary Open Angle Glaucoma" (POAG) also sometimes call Chronic Open Angle Glaucoma (COAG).

You can't simplify it as you did. You can have glaucoma with pressures less than 20 (lo tension or normal tension glaucoma), you can have pressures over 30 and not have glaucoma (glaucoma suspect). However if damage to the visual field and optic nerve is present then glaucoma is likely present. By the way damage to the optic disk occurs first--so its possible to have an abnormally large and damaged cup/disk ratio and normal visual fields.

Ophthalmologists are extremely excited over a new technology called optic nerve OCT (optical coherence tomography). OCT is a leading indicator. It measures the first evidence of glaucoma damaging the nerve fiber layer of the retina (it becomes thinner). When enough damage occurs the optic nerves starts to get 'cupped" then finally after enough damage is done to the ganglion cells of the retina and the nerve fiber layer (Perhaps as much ad 50% of more damaged) the visual field changes.

You should take heart as ophthalmologists (Eye physicians and surgeons or Eye MDs) have 4 family of drugs to work with that are additive in pressure lowering effect. Within each of the 4 families there are several different brands that can be tried. Then there are two different kinds of lasers (ALT of argon laser trabeculoplasty and the newer SLT or selective laser trabeculopasty) to try is drops don't work or if the patient cannot put drops in their eyes. Lastly there are several types of traditional surgery usually called "Filtering" surgery that can be used.

You should take heart. Most cases of glaucoma can be controlled one way or another. Most of the people that go blind due to glaucoma either were not diagnosed until most of the optic nerve was severely damaged or are non-compliant and don't use their medications or keep their appointments to see their ophthalmologists.

Your use of your eyes has no effect on your eye at all. It will not cause glaucoma or any other eye disease. Perhaps some eye strain or watering but never, ever will it cause glaucoma, cataracts or physical damage.

[NicoNicola]

So despite the pressure on my eyes and the cup difference you think the odds are in my favor? And it was a regular eye doctor.

[JohnHaganMD]

Yes many people without glaucoma have pressures in the lower 20's, it's also possible the reading was in error if you had an inexperienced tech or were squeezing.  Grading "cup to disk" ratio is notoriously inaccurate and highly subjective.  Did you see an Eye MD ophthalmologist or a non MD optometrist?  There is no such thing as "regular eye doctor" it's either MD or OD optom

[NicoNicola]

Thank you for answering! I believe he was a non MD since he referred me to someone else to have my test taken. He even said that I may not have it and to not get excited, but in the same vein he said I had two red flags and had to count in my grandfather in my family history. If it does matter I was a bit nervous in the office and I haven't noticed any vision changes.

[JohnHaganMD]

You won't notice changes in your vision from glaucoma.  LOOK AT YOUR REFERRAL. If you were referred to an Eye MD ophthalmologist keep the appointment. If you were referred to an optometrist (OD) then contact your family MD and see and Eye MD.