Iridotomies and steriod eye drops

[ejp1978]

Hi, I had an iridotomy on both eyes recently for narrow angles as a preventative measure, the eye doctor prescribed me Maxidex for a week after surgery. Within 3 days I had severe pain and decreased vision and I call the hospital to be told the blurred vision and dizziness I was experiencing was normal side affects of this surgery. I was told to continue with the Maxidex. The next day (day 4) I was in worse pain and vision so I called again and they asked me to come into the surgery the next day still contnuing to use Maxidex!  I went to the emergency department that evening as I experienced coloured rainbow rings around all lights and everything shiny and the blurred vision and pain was becoming quite severe. The emergency department again said I will call the on duty Opthamologist but he said come back tomorrow as it was an existing problem (I had never had problems with my eyes before the iridotomies). The doctor and on call opthamologist on the phone said if I lose my vision come back - hardly very helpful! Surely that would be an horrific outcome!

I went home very upset and preyed I would be ok until the next morning (my dad had an attack 2 years ago and had these very same symptons but lost vision in one of his eyes for 8 hours - lucky for him it was recovered). I woke up in pain but knew I was off to the hospital so had some assurance I would at least be looked at.

I went to my hospital appointment and explained my symptons and my pressures were checked - they were 58 in both eyes! I was given lowering pressure drops and within 20 mins was having the iridotomies redone by a different
doctor. I was at this point in severe pain but after the laser felt so much better within an hour.

Basically I was re checked within an hour and the pressured were reduced to 34 and 36 and was taken off the steriod Maxidex. I was re checked two days later and my pressures were 24 and 26 (all good). My pressures range naturally between 20 and 26. I was then asked to go back on the steriod eye drop Lotemax which I was very worried about as the steriod eye drop Maxidex had caused my pressures in less than a week to rise to 58! But they said I had to so I started Lotemax and Iopidine.

I took myself back to the hospital 3 days later as I felt increased pain and my pressures were rechecked at 30 and 36. I mentioned is this the steriod as 3 days ago they were 24 and 26! He replied Lotemax is not known to raise pressures and I must continue and he also prescribed me Timolol.

I am on Lotemax for 3 weeks (3 times 1st week, Twice 2nd week, Once 3rd week).  I have tried to talk to the docs about any damage I might have occurred with pressures of 58 as for how long could they have been that high! But they do not reply.

I am truly upset with the outcome and am hoping for ome advice in your experience whether pressures of 58 and my continued use of a steriod Lotemax is causing continued damage to my eyes which before the irrodotomies were perfectly healthy.  I might add the procedure itself has only caused me white horizontal lines in my vision and slightly less focus but I understood from forums online this may be the case although the doctors performing told me of none of these side affects.

Do you think the Maxidex caused a glaucomatic attack with pressures at 58 or can my eyes have been caught in time.  58 seems horrifically high to me, by the way the first iridotomies were a failure hence having them redone.

I really appreciate any comments you have and thanks for taking the time.


To cut a long story short I woke up and no

[ejp1978]

Hi - thanks for your reply, now I have the two holes from the repeat iridotomies that I am now told are quite large will this mean my pressures will never go up to a threatening level again i.e. 58! When do the holes from iridotomies start to drain or help with pressures.

Thanks
Emma

[Ray T Oyakawa, MD]

The need for the repeat iridotomies suggest that either the initial treatment was incomplete or closed.  Lotemax can cause steroid induced glaucoma in some patients.  A short time pressure of 58 will usually not cause permanent damage unless you already had some nerve damage.

Dr. O.