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low pressure glaucoma?
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low pressure glaucoma?

Bear with me if this is too long, but I'd like to hear some opinions.

My ophthal. has recently diagnosed me with low/normal pressure glaucoma.  He says I also have some cataract in the same eye.

History:  I am a 51 yr. old female.  History of high blood pressure and high cholesterol.  I've been on medication for both for 6 years and both are being successfully managed.  I had occasional migraines as a teenager and adult, but have not had a single one since being on the blood pressure medication.
My vision has always been good, until my mid-40's when I started having to use "cheaters" for reading.
I had never been to an optometrist or ophthal. in my life until a couple of years ago when I sought relief for a pinguecula/pterygium in the affected eye.  Therefore, my optic nerve had never been examined.  Even two years ago, the ophthal. did not examine the optic nerve.  He treated my pterygium with tobradex, then lotemax, then tried to wean me off of the steroid drops, but none of the "lesser" drops relieved the very uncomfortable symptoms of my pterygium.  After approx. 8 months of treatment with mostly lotemax, we decided to remove the pterygium. The surgery went fine. (BTW, my ophthal. monitored my eye pressure the whole time I was on the lotemax and it was always in the normal range.)
However, about 6 weeks after the surgery, my eye began to water constantly and the corner of my eye (the fleshy part) was a little inflamed and itchy. The ophthal. said my drain was clogged so he unclogged it and put me back on lotemax.  After a little while, the tearing went away only to return a month or so later.  He unclogged it again and this time put me back on tobradex and an oral antibiotic.  The tearing cleared up very quickly but I contined to use lotemax afterwards as needed for eye irritatation.
Finally, around Thanksgiving this year, (about two months after the last episode) the tearing began again. But this time I noticed a change in my vision.  There appeared to be a faint grayish mottling in my vision, like I was looking through a net or veil. My vision in that eye was also more blurred than in the healthy eye.  When I went back to the ophthal. he dilated my eye and realized that my optic nerve was quite damaged.  But we have no idea how long it has been that way.  My pressure continues to be normal.  He ordered an MRI--normal.  Field vision test was BAD.    At one point the ophthal. said, maybe he wasn't seeing the forest for the trees and it is the cataract that is causing the visual disturbance. Recently had the visual evoked response test and it also had abnormal results and once the ophthal. and the neurologist discussed the results of the visual evoked response test, the ophthal. is going with the diagnosis of low pressure glaucoma.  (My eye pressure has always been in the teens.)  I am on travatan and Istalol  to further lower the pressure, and my vision in that eye continues to be kind of mottled with only a few truly clear spots.

Oh, yeah, I also had Bell's Palsy on that same side of my face 6 years ago.  I occasionally get vestiges of the Palsy--like twitching, tingling and occasional pain in my ear.
My bloodwork and urinalysis are normal.

Any thoughts or opinions on all of this?  Does the diagnosis sound reasonable?  My ophthal. keeps asking me if I've ever had any eye trauma or infection (to explain the damaged optic nerve) and I haven't, except for the removal of the pterygium.  All of the other symptoms of tearing and visual disturbance occured after that.

Thank you for readiang.
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233488_tn?1310696703
I think it is very important for you to get a second opinion from a Glaucoma Specialist to sort this pro blem out.

Find one in your community or near you at www.aao.org

I think this is very important.

JCH III MD

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