Long Acting Muscarinic Agonists—used to be Spiriva and now a combo medication, Trelegy/
Double whammy. Pupil dilation increasing risk of narrow angle attack and steroid with risk of IOP rise. That said, if your angles are open, no risk from the first (only your doctor will know that) and IOP rise from inhaled steroids is rare.
Newbie to this—mom was on drops for eye pressure probably last 40 years of her life, seemed to manage things. Her sisters have/had glaucoma as well.
Two years ago my pressures crossed the 20 psi threshold. Had the SLT laser in both eyes twice–pressure drops for a while then comes back up. Pressure 6 months post SLT is only 1 psi lower in each eye.
So I start the drops (latxxxxxxxxx) today at bedtime.
I’ve already had cataract surgery, so adding the stent at the same time is not an option.
Technically, I guess what I have might be called pre-glaucoma? We’re trying to keep the pressure down BEFORE retinal damage starts, I guess!
Thanks for your post. Interesting you had laser procedure before using drops. I imagine it depends on individual situation.
My pressure readings this week were about 16 (with nightly Latanoprost drops). I think they are usually in the range of 13 to 18. Never over 20. My mother had different/pricey drops, twice daily. By the time we talked about her eye doctor visits she was probably in her 70s. Her readings (with drops) I think were well over 20. Can’t be sure if she lot any eyesight due to glaucoma. Definitely she seemed to have issues from deferring cateract surgery too long.
@eyemgh can verify…but I do not think this is true. I have no retinal damage, and no vision loss yet…but Inhave glaucoma.
My understanding is that glaucoma is optic nerve damage (often caused by high pressure), but that high pressure with no damage is not technically glaucoma.
also wanted to add, when his ocular hypertension was originally noted, my H’s pressure was almost 30. Drops and now this trab surgery have brought it down, but it is still well above 20 (22 or 23 usually). He has been told he has very thick corneas, and that makes it harder to get an accurate reading (readings tend to err on the high side).
I also was told my corneas were thick (they measured the thickness and adjusted the pressure reading accordingly.
So I guess the debate is whether glaucoma is defined as retinal damage due to increased pressure, or simply the state of high pressure itself. My ophthalmologist did say that we wanted to get the pressure down before there was any damage, never actually saying I had glaucoma, but wanted to prevent it.
Semantics, I guess.
I also had the test years ago, showing that my pressure reading might be higher due to thickness… ie not as concerning as it seems at first.
Originally I remember hearing the term “glaucoma suspect”, when I had high-ish pressure. I assume now that I am on eyedrops and having all of the the testing appts charged to medical coverage (not vision plan) that it is considered glaucoma diagnosis.
Very atypical in the US, because SLT/ALT has a limited lifespan, and isn’t very effective if repeated. Plus, in the above scenario with just IOP above 20, and no other findings, I’d argue that laser in that situation verges on malpractice.
Glaucoma suspect is a billable diagnosis.
It’s not just IOP elevation. It’s a very specific optic atrophy of which IOP elevation is one risk factor.
There must be more to the story or that would be very atypical.
Well, I did get a scleral buckle 30+ years ago for a detachment, and have a thin area of a retina that’s been watched for several years now, so you might say my retinas are not in “mint condition”.
I learned something new today and it’s reassuring. Thank you. I’ve gotten such varying results on IOP tests and conflicting information from various doctors as we’ve moved over the years; it can be very frustrating. Both glaucoma and macular degeneration (not for the same reason, of course) have been mentioned by doctors only to be contradicted by the next doctor. As long as the latest one is saying there’s no sign of damage then I won’t worry.
Your myopia does increase the risk of glaucoma, but doesn’t really enter into to treatment decision matrix.
I’ve only got one good eye for vision - the other had subretinal vascular degeneration resulting in no central vision. Because of this, my ophthalmologist opted to be aggressive with starting glaucoma treatment. Currently using Dorzolamide /Timolol drops. Pretty amazing that just using eyedrops can prevent blindness!
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