Med to lower eye pressures

[running_man]

Hi,

I'm a 44 year old male. I am nearsighted and wear contacts. (-3.25 right, -4.5 left) Originally, my pressures had been 17-18. But over the past 4-5 years my eye doctor has been monitoring my eye pressures. They have been elevated but my visual field testing has all been good. My cup/disc ratios and nerve analysis have been borderline from what I remember. Something where it could indicate a problem but not definite. My grandmother had glaucoma and used drops to lower her eye pressures. My doctor has been taking a wait and see approach based on the thought that most occular hypertensives don't develop galucoma.

Just had a 6 month check up visit where my eye pressures were 32 and 26. 6 months ago they were 26 and 24. (these were all measured on the eye) This time my doctor gave me the option of starting medication but felt we could have me come back in 2 months and recheck. He said he would want to be sure before starting meds just because it typically becomes a lifelong committment. So, I opted to wait and see.

My doctor is a specialist in treating glaucoma so I'm pretty confident in his recommendation. I'm just second guessing now whether it would just be best to start trying to lower the pressures. I don't want to wait until there is damage to start the meds. I read somewhere that once the eye pressures get above 30, there is a 42% chance of developing damage from galucoma.

Just wondering what others have done.

Thanks

Just wondering if I should just

[Sandra M Brown, MD]

Don't worry about the Cymbalta.  You almost certainly have open angle glaucoma.

The decision to start treating eye pressure is indeed a "lifelong" commitment. If you think it's important to lower eye pressure then you have to get it lower and if the medications all cause nasty side effects, you can't quit.   Your glaucoma doc making a nuanced and very up-to-date recommendation that you hold off on treatment.

[running_man]

Forgot to mention that my family physician had started me on Cymbalta 3 weeks ago. It has a warning for patients with uncontrolled narrow angle glaucoma. In my case, my eye doctor told me I don't have the narrow angle varient so he didn't think it should be an issue with the cymbalta. Still, in reading cymbalta's possible side-effects, it lists increased eye pressures.