re intra occular pressure, call IOP
.Hi Darlin,
Me again, telling all I know, and that does not take long. I am so sorry to hear you are still having eye troubles. Myself, my k sicca is driving me insane, goop, crusties, blurries, but it is the price I pay for AS, huh!
'Anyway Hon, here is all I know about glaucoma. I have been retired a while. I do know that as far as excitng research in ophthalmology goes, glaucoma has come a long long way in the last 10 yrs. A whole lot more can be done today than was available in our parents day.
The America Academy of Ophthalomology does not recognize any term "autoimmune eye" there is no syndrome or illness called this,there is no billing code for it, there is no diagnosis code for it, so what is they guy talking about? One thing that never changes, if it exists, a dr will bill you for i!
Elevated pressure, red eye, decreased va, and epiphora....if you have light sensitivity it would sound like you are having an inflamatory response in the first order!
Glaucoma, definiton....when the pressure within the globe of the eye is sufficient to cause damage to the optic nerve, inducing permenant loss of peripherial vision. Fluid is made by the eye, it circultes all within the eye, providing nutrients, and lubrication for the eye. There is production, and out put. When fluid causes excessive or untolerated occular pressure, you have 2 choices, reduce the production, or increase the out flow.
Primary glaucoma is because yor are genetically programmed that way. Secondary glaucoma can come from medecines or disease, like INFLAMMATION. The prescence of inflammatory cells within the vitreous can cause elevated IOP.
nickname, sneak thief of sight, there are NO symptoms except in cases of acute angle closure galucome which is EXTREMELY ACUTE and an emergency situation. NAG isaccompanied by nausea, vomiting, halos arond lights, extreme unrelenting pain, red eye, major light sensitivity, epiphora (where tears run down the cheek). So if you have primary glaucoma, I supect you have some other eye troubles going on also. Like my doc says, just because you have AS, does not mean every thing you wil have s AS relates sweety, you an have more than one flavor of pain. Ahh he is so reassuring, huh, LOL.
The normal range of pressure is less than 21mm of mercury by applanation method, the industry standard. There are lots of ways to check, this is the MOST accurate. Pressure is diurnal, meaning it changes with the time of day. Patients beign worked up for Glaucoma often have their pressures checked by the techs, several different times of the day.
When it is suspected that pressure might be causing damage, a test called visual field, or perimetry is ordered. The test consists of looking straight ahead, while indicating with a button, when you notice a light go off. This test is the only way to detect if the optic nerve is sustaining damage, before the damage is so far advanced, it is visable to the naked eye. There are a million ways to do these tests lso, the industry standard world wide is a humphray octopus. a big half circle device, you rest your head on a chin rest, looking into the bowl, in a dark room. While looking ahead, lights in th sides flash. You push a buttom every time you notive a light out of te sides of your eye. Each eye is tested individually. Then the machines computer, plots your flied and any defects. Often, in glaucoma, one of the first defects, is an island looking black spot.
The damage done by pressure is called optic nerve excavation, it begins as an "island" defect. Damage to the optic nerve is not reversable. Vision lost from elevated IOP is permenant.
There is low tension glaucoma where the pressure is within nornal limits, but the eye is not tolarant of that pressue and needs a lower pressure. A visual field again, is the only way to follow this.
Cells and flare (intraoccular inflammation)can cause secondary elevations in pressure. Steriod drops used to treat eye inflammation can cause elevated pressure, this is called a steriod responder. They can also cause a rebound effect, where you swell when you stop them, usually this means they were not tritated slow enough, or that patient is a steriod responder.
The treatment for glaucoma is varied. There are lots of drops, beta blockers are the first order meds. The reduce the amount of fluid the eye makes. Not for patients with heart or lung problems. Some of the newer ones claim to have minimal effect of coronary an respiratory systems. SOme meds come in implants that are put on the outside of theeye, no preservatives to irritate the eye.
The other drugs and procedures address increasing the fluids exit out of the eye, but making the exit channel as large as possible by miosis, making the pupil very small. This med is called pilocarpine. It is often the second try, after beta blockers.common side effects of this drug are headaches, brow aches, blurry vision, unable to see at night.
Surgical procedures to lower pressure include a laser iridotomy, a small hole is put in the iris with a YAG laser, painless in office procedure.(YAG iridotomies are extremely safe and successful with no real significant side effects!) Then there are iridectomies, where a pie shaped weg is cut our of the iris, increasing the fluids outflow. This is done in a surgical suite, with local and a general standby, like a cataract procedure.
Often a combination of reducing production and increasing outflow are used.
The world of glaucoma is intricate, and complex.But treatment is highly successful under a skilled practitioner. There are eye dr's that see nothing but glaucoma, it is that complex. Vision lost to this beast is not to be recovered. I would, if you were my cousin, nag at ya to see a glaucoma man. Get a second opinion from someone that sees only elevated intraoccular pressure, the glaucoma man! I have a friend who sees someone in Boston forthis disease. If I can find his number, I will forward the info.
again, my silly disclaimer.......I am NOT A DR, just a retired ophthalmic medical technologist. What I do know is that, an expanded blind spot is called a small island, it is an marker that the optic nerve is unable to tolarate the pressure within the eye. It may indicate vision has already been lost. Being a disease of the periphery, it is IMPOSSIBLE for anyone to monitor their own loss. I have seen people not notice any change in their "side vision" untill the 4th wreck, and they were left with what our parents called tunnel vision, and that is sad, and needless.
So again, I will nag at ya like you are family, go get another opinion, if ya cannot afford it, let me help ya find a siding scale or make ya a loan or something!!!
I am praying for ya darlin!
Love and strength to you
Shu
