Having a problem tonight

[AnnaE]

I have low pressure in my left eye, after 5 retina surgeries. My eye has been doing better--up from 2 to 7 sine my last surgery.

Historically, my eye loses pressure when I have bouts with ashtma, as a result of having been exposed to chemicals. My pressure went down to nothing  in 10/2007 when I was very ill with bronchitis and asthma. It has been going up and down for three weeks. I have asthma really bad from exposure to strong irritants. My eye is a lot smaller today, as it gets when I am ill, only it's a bit worse. I called the very nice tech from my retinologist's office, and she told me to get artificial tears. I see the doctor on Monday.

I am very weak from asthma, and I think it would be a mistake for me to go out. I have Pred Forte here[ it is prescribe for me 2 times a day now. I think that inreasing the Pred Forte to six times a day makes more sense that artificial tears. The eye is smaller and irritated. It has done this before, from illness. My former doctor gave me these directions when it became very small, when I was ill. I do not know if you can tell me anyting. Just let me know if you can.

Maybe I should try both. I an rest a while and go later.

[AnnaE]

I have no lens; they call it count fingers. My first retinologist has me using pred forte once an hour. Before the fifth surgery, my pressure was less tha 4, After the 5th, it was at 6, the down to 4, up to 7-8, where it has been for 0ver three months. Surgery was 7 months ago.

I think my 2nd retinologist will let me go up to 6 times a day; I will ask him tomorrow..

My eye is has been looking so good lately, until the exposure to chemicals three weeks ago. I started oral steroids for the asthma last night, in addition to the systane, and the usual restasis, and increased pred forte to six times a day. My eye is worlds better today. Two retinologists and my opthalmologist say I will keep probably keep my eye, My opthalmologist is also an eye plastic surgeon. I have also consulted with Iowa ocular plastics, to try to prepare myself. My opthalmologist says she can find a really good person here in Texas, who will take my insurance. The people in Iowa would not.

My eye acts poorly when I have allergic and non-allergic rhinitis, bronchitis, sinus infection,asthma. These are chronic problems, due to the chemicals people throw around, and sometimes to mold.

I already have PTSD with chronic depression and anxiety; losing my eye would be an incredible burden for me in many ways. I have no family emotional support. I would do anything to save my eye.

I am thinking of seeing a Castle-Connelly top in the nation rated doctor, within the next three months. The glaucoma spec said we could shoot a gas bubble in there, but the retinologist said no, that my eye is worn out from all the sugeries as it is.

Beause of the non-allergic rhinitis,I work at home, and do not go outdoors much. I work at home. But I still run into chemicals in stores, and buildings, and all around.

I might have to move. I am working on building my immune system, but no MD has helped yet. I am working with a new allergist. My IGg is low,

Thsnkd for your help.

[Michael J Kutryb, MD]

Systane is just fine - it will help with irritation.  Regarding the low pressure possibility - it's hard to know what your pressure it right now?  We're assuming it's low and it probably is.  Your eye sounds like it is in pretty bad shape and I'm guessing 20/400 or count fingers vision.  I've seen patients like you on chronic once a day pred forte but this might not be a good idea if you stil have your natural lens since the cataract will grow quicker.  If already had cataract surgery - I don't see nearly as much problem with taking pred forte unless there is a risk of herpetic or fungal keratitis.  Anyway - it is not proper for me to give you advice about the pred forte - but it is one of the few things that can raise IOP (and if you went so far as to use ibopamine, you definitely know that steroid drops can do the same type of thing - raise IOP.)  I'm actually curious why you are not on it more?  I don't know your case though.  You have a pretty good understanding of things.  MJK MD

[AnnaE]

I bought systane. I went to the giant grocery, because they have a 24 hour RX.

Systane has a lubricant, in addition to the moisturizer. It is 6% propylane (?) gly______.
"Artificial tears" is 9-10% pg. I think Systane is OK. They told me to get artificial tears.
I will take prednisone for asthma, and use pre forte and systane for my eyes (along with my usual atropine.

I will check with the tech later today, to find out if the systane is OK.

Thanks

[AnnaE]

Thanks for your message.

No one has mentioned pure alcohol. I will ask my doctor.

They think my eye will make it.I am just worried about it getting lower when I get sick.I am also using atroping twice a day.

My doctors say that pressure can rise on its own. It is a good sign that my pressure has gone from 2-7 in a short tome after the last surgery. BTW, it started rising after I started the atropine--got the idea from a glaucome expert. My eye has been looking beter and better--gettin larger, firmer,

I contacted Dr. Thamas Ciulla of Indianopolis and got the glaucoma expert idea from him.

I tried ibopamine from Europe, but it helped only temorarily, as is its reputation, except for one study on a man who had uveitis or something.

[berrywoo]

I'm sorry to hear of your problems w/low eye pressure.
My doctors say there is really no permanent cure to low eye pressure. Steroids may raise the pressure, especially if you're a steroid responder, but generally it is not given on a permanent basis b/c of the side effects. Also, if the eye is always small or is shrinking (aka phthisis bulbi) and is painful then enucleation may be an option, although other options exist, like pure alcohol injections. I'm sure you know this already and have discussed this w/ your doctor, though.
Hope you feel better soon.

[AnnaE]

I just called my allergist, I have to go to get the prednisone he prescribed for me. I guess I will try both atrificial tears and pred forte.

The assistant at the eye dotor said the PF would raise the eye pressure. I am sot sure why she was against that.
My old dotor thought that was good.