Painful blind eye

[jenx2000]

In 1995 my retina completely detached and I was diagnosed with glacoma.  They treated me for a few years with eye drops, but I wasn't having problems so I haven't been treated for years.  I've seen eye doctors regularly, but had no problems with my left eye.  Three years ago I started having headaches with pain behind my left eye.  These headaches also made me lose my ability to remember everyday things.  I was diagnosed with a special type of migraine.  Recently the pain has gotten worse.  In the past 2 weeks I've been to 5 doctors and they all tell me something different.  My eye doctor said the pressure was increased and I should have a procedure where they use a laser to relive pressure.  He sent me to a surgeon.  That surgeon said the laser wouldn't help and I should have the eye removed.  The surgeon I went to for that said the eye didn't need to be removed and removal may not help with pain.  The other 2 doctor's said it's up to me.  Last night I had another acute episode and ended up in the ER.  We ended up going through the same options with the same doctors and ended up in the same place, no where.  What do I do?  How can I stop hurting?


This discussion is related to Occular Migraine? Retinal Detachment?.

[John C Hagan III, MD, FACS, FAAO]

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[berrywoo]

Like Dr. Hagan suggests, you could always get another opinion.

Do the doctors know why you are experiencing the pain? If you do have closed angle glaucoma that would indeed be painful. Is there any other reason for the pain?

If the pain is just from the glaucoma and you have no vision at all (not even light perception) then you've got to eventually make a choice. I can't tell you which route to go down. However, if I had an eye that was totally blind and cosmetically it appears "normal" then I would opt for the laser, first. If laser did not work, I'd ask about alcohol injections for the pain. But if the eye is not "normal" cosmetically speaking (pthisis bulbi) I would opt for removal.  
I know the decision will be hard and to make matters worse you're in a lot of pain right now.
I suggest you find out exactly what is causing the pain and the best ways to deal with it.
Please keep the community posted. Wishing you the best.

[John C Hagan III, MD, FACS, FAAO]

Dial in a third opinion.

JCH MD

[jenx2000]

Thank you for your comments. The first ophthamologist said the pain is due to an acute closed angle glaucoma, but the surgeon said the laser surgery is only used to save vision, and I have no vision in my left eye. He believes removing my eye is the best option.  But, the surgeon who was going to remove the eye doesn't think removal will help the pain.
jenx2000

[John C Hagan III, MD, FACS, FAAO]

Suggest you see a glaucoma specialist to discuss a cyclodestructive procedure. If that doesn't work and the eye is blind you may need to have the eye removed. There is something worse than a blind eye and that's a blind PAINFUL eye.

JCH MD

[berrywoo]

meant neuro-ophthalmologist, not oculoplastics (although, if you do have phthisis bulbi this is the specialist you'd want to consult with)

[berrywoo]

Personally, i would go with the least invasive procedure, first. If that doesn't work then proceed with the other options.

If you've seen an ophthalmologist and he/she says the pressure is high that should be treated. If the IOP elevation is caused by a narrow/closed angle then get it fixed as this will get rid of your pain. Why did the surgeon say you wouldn't benefit from the laser? Is your eye symptomatic for phthisis bulbi?
Go see a glaucoma specialist and maybe an oculoplastics specialist.