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OCULAR HYPERTENSION

Hello....3 months back I was diagnosed with Ocular Hypertension....VFT was normal....Dilated eye exam was also normal....I want to know that what are the chances of OHT turning to Glaucoma....Can i live my life without going blind with medications like timolol etc...Or surgery
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233488 tn?1310693103
MEDICAL PROFESSIONAL
You are greatly exaggerating the risks of OHT.  First it may not ever turn into glaucoma. Second if it does treatment would be able to be started early.  Less than 1% of glaucoma patients that are diagnosed early and use their medications and are followed by an ophthalmologist 'go blind'.  Most blindness from glaucoma comes from late diagnosis or not taking medications or returning on a regular basis to an ophthalmologist. First be sure you are getting your eye care from an Eye MD ophthalmologist. Their skills are greater from determining when or if OHT would need treatment. The risk of getting glaucoma cannot be predicted without know things like: your family history of glaucoma, the level of pressure, the thickness of your cornea, your baseline visual field, your nerve fiber layer OCT and refractive error.  So at this point the best thing is be sure you are seeing an Eye MD ophthalmologist that treats and is competent in glaucoma management. And stop worrying so much, risks are low if you are compliant.
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21 Comments
Thnks a Lot Sir for your prompt response.....I am seeing a MD Sir...I am only 29.....Have no family history of Glaucoma....Married recently.....My VFT was normal.....My RNFL thickness was 99 in left and 87 in right....I wear spectacle of -3 in both the eyes ...My todays eye readings are 18 and 16 respectively ( after using timolol once a day for 8 days).....Now the doctor has asked me to continue timolol for 2 weeks twice a day....This is creating a havoc that even after the normal eye pressure why he wants me to continue timolol twice a day..... I went to the doctor for some blurry vision due to watery and heavy eyes.... Kindly suggest If these details can help a bit

And For the sake of satisfaction....Can I please know....That If I start the treatment if suggested by the doctor...Can I will be able to stop my vision from getting worse....Or upto a level where i can see for the next 30 40 years .
One More thing to add Sir....I am an IT Professional.....I have to spend 10 to 12 hrs daily on the laptop....Do I need to quit my job due to this OHT....And Can I Go for a laser for glass removal once the pressure comes back to normal.....
Yup:  I would VERY STRONGLY suggest you get a consult with an Eye MD ophthalmologist that specializes in glaucoma. I would do this ASAP.   First of all there is no indication from what you sent that you even have glaucoma.  SECOND and very important. Physicians almost NEVER start off treating with timolol. If you need treatment, which is likely you don't, you should have been offered selective laser trabeculoplasty which might control the IOP the rest of your life without drops.  If SLT didn't work or you did not want last then you should be tried on latanoprost which are inexpensive, very few side effects and only used once/day at bedtime.  I only use timolol, a beta blocker, as the last resort when no other drops work.  The drops have many side effects and are not well tolerated by young people.  I have been on beta blockers for a heart rythm problem and they almost killed me.  Things you likely have experienced on timolol:  loss of energy, fatigue, inability or difficulty exercising, cold feet, low blood pressure, slow pulse. With long term use often causes  chronic cough, wheezing and nasal drainage. GET A SECOND OPINION ASAP.   You do not have to change or stop your job.  If you have access to a medical school with a department of ophthalmology, they almost always have a glaucoma specialist. Where do you live?  WHAT WAS YOUR PRESSURE BEFORE DROPS STARTED?
Thnks Sir....Will SLT lasts lifelong??

Sir before the drops my pressure was 24 and 23.7 in R and L resp.
Sir the doctor who wrote this prescription for me is Mbbs, MS , eye surgeon.....And Yes....U r absolutely correct,.....I am having a slow heart rate problem after using these drops....I felt a little uncomfortable during bedtime after using these dropa for 8 days....Was thinking what be the reason....Now After your text....I understand the reason....Thnks a lot Sir....

One more thing i want to to know Sir....what will be the ideal pressure goal for me??
I feel strongly you need to see a glaucoma specialist as soon as possible.  The material you have posted do not indicate a reason for most ophthalmologists to begin treatment at all, most would just follow with regular IOP, visual Fields, and nerve fiber laser OCT.  I cannot tell you to stop the drops but you should report side effects to your 'eye doctor' immediately.  Depending on how comfortable you are with the doctor, you could say you want to stop the drops and get a second opinion from a glaucoma specialist.    SLT laser often lasts for the persons lifetime. If it wears off after 4-8 years it can be repeated.  Again timolol is NOT a good choice for a first medication for glaucoma.  Be assertive.   The pressure in your eye changes from hour to hour. The average pressure is 21 or less.  It is also important to know the thickness of your cornea thickness as if your cornea is a little thicker than normal the true pressure may be lower. BE ASSERTIVE. GET A SECOND OPINION.  Ask again where do you live.  
Respected Sir....I Live In India

Pardon me for missing your question at the first place.

And Thnks for your kind help and suggestions.....It really helped me a lot
Please act on these suggestions, as I don't feel you are getting appropriate treatment based on the information your proved. Best of luck.
Hello Sir....Today I went to my doctor for further evaluation.....Pressure today was 10 12....at 1 l0nam....And i used timolol yesterday at 10 pm.....Gonioscopy shows that all channels in both eyes are open....But still my doctor wants to go for HVF and RFNL OCT....They both were normal some 6 7 months ago.....I am unable to understand.....Neither he is denying nor accepting anything about Glaucoma.......Kindly suggest whats ur views regarding my recent diagnoses
It is important you understand that in this forum we do not practice medicine or establish a doctor patient relationship. We generalize from the data and material supplied by the poster.     If your HVF and RNFL OCT are normal, you are young, have no strong family history of glaucoma and your highest pressures were low 20's it is not likely you have glaucoma or that you need treatment.  AND if you did have glaucoma there are much better options than beta blockers like timolol. I have taken this about as far as i can. I will end by saying I would see a glaucoma specialist ASAP and if your are having side effects from timolol like fatigue, low blood pressure, etc discuss stopping the medications with your present ophthalmologist.  That is about as much as I can say.  India has many find ophthalmologists, get busy finding one that you can get to that specializes in glaucoma. I will not be able to continue this dialog.
Ok Sir..Thnks for your kind responses....
Just a last question....Related to OHT....when all the fluid gateways are open and normal as per Gonioscopy.......How is it possible A patient has OHT
One of two mechanisms:  1 the eye is producing fluid (aqueous) too fast for the drainage system (like flooding when it rains hard) or more commonly 2. the blockages exist on a microscope level invisible to gonioscope.   Do a intenet search of "images of the eye trabeculum with and without glaucoma"   Gonioscopy is only good to rule out angle closure glaucoma, and see evidence of previous trauma and to see the amount of pigment in the drainage area (trabeculum) which can indicate how successful SLT might be and if pigmentary or pseudoexfoliation glaucoma is present.  THAT IS IT. LAST WORD GET A INDEPENDENT SECOND OPINION, IDEALLY FROM A GLAUCOMA SPECIALIST IF NOT AVAILABLE FROM A GENERAL OPHTHALMOLOGIST THAT DOES A LOT OF GLAUCOMA WORK.
Sir.....If I go for SLT laser....Is it possible for me to maintain my eye Current vision for the rest of life with or without Glaucoma (leaving aside the age related vision loss)??

By Timely visits and routine check ups prescribed by the Doctor..
Sir One Question on the explains tion u gave above regarding the Gonioscopy....Id Microscopic hurdles are their in the passage...Arent laser technique can be used for opening that way ...Which automatically nake you a normal person
I will have no further comments.
Ok Sir.....But only one answer.....Why I feel sad after waking up....Why It feels that soon I am goong to get blind....Why is it nt possible to tell that will the treatments able to maintain eyesight throughout the life.......
Respected Sir...May I Know the Limits and boundations which I have to follow while using this platform so that I will understand my limitations and will not irritate you....I want to learn more and more about this disease.....
You are going around in a circle. I don't have the time or inclination to continue. HAT IS IT. LAST WORD GET A INDEPENDENT SECOND OPINION, IDEALLY FROM A GLAUCOMA SPECIALIST IF NOT AVAILABLE FROM A GENERAL OPHTHALMOLOGIST THAT DOES A LOT OF GLAUCOMA WORK.
Yes Sir....I agree with you.....I am going around a circle.....I promise....I will nt Exaggerate from now....Just ask you only a single time.....Thnks again for your all the suggestions.
Hello Sir....I have a question...Is tunnel Vision considered as a legally blind state??

As I came to know after reading that Glaucoma causes Tunnel Vision..
Hello Sir....Can you please tell me that using dumbbells for biceps increase eye pressure .....Can we do this in OHT
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