Science & ResearchLatest Questions and Answers I had glaucoma surgery on both of my eyes. After the surgery, the vision in my good eye (left) became bad and cannot be corrected by glasses. I began to see double and my vision became fuzzy. My doctor told me that my bad eye may be wandering or my good eye may have developed nerve damage. I am afraid that my doctor is not giving me the whole picture. It has been 7 months now and my vision is deteriorating. My vision was clear prior to the surgery. Did the glaucoma cause the nerve damage? [ 01/15/09 ]
There are numerous types of glaucoma surgery, with the most common being either trabeculectomy or tube shunt surgery. Blurred vision after surgery can be due to induced astigmatism, ocular surface disease (abnormal coating of the tears on the surface of the eye), corneal edema, low eye pressure, swelling in the retina (macular edema), progression of cataract, and worsened optic nerve damage from glaucoma, for example. Various tests of your “good” eye should be able to determine the cause of the blurred vision and thus possible treatments. Such tests might include refraction, corneal topography, optical coherence tomography (OCT), and visual field testing (specifically of the central 10 degrees of vision). I am a 28 year female, have had dry eyes for 2 years and am using Restasis and Refresh on a regular basis. During the last 1.5 years my vision has progressively gotten worse (especially in my right eye). I constantly feel pressure in my right eye, especially after I wear my contacts or at the end of the day. Also, I feel as though the vision in my right eye is worsening again even though I just had my lens prescription changed about 4 months ago. I've seen two optometrists and one ophthalmologist to have my eye pressure tested. I was told that there is no problem and that my symptoms are just related to my dry eyes. Any suggestions as to what might be causing the deterioration in vision? [ 01/15/09 ]
Dry eyes can cause many symptoms, including blurred vision, headache, sensation of eye pressure, and eye pain. The pressure sensation you feel in the right eye is worsened at the end of the day and after contact lens wear. Both of these conditions are associated with times of maximal dryness in patients who suffer from dry eye. You have already seen numerous eye care providers for eye pressure measurement and the consensus seems to be that your symptoms are related to dry eye. If your dry eyes are worsening, seeking an opinion from a dry eye specialist (cornea/external disease specialist) may help with treatment options to lessen your symptoms. What kind of vision loss would be expected if glaucoma is diagnosed and the nerve damage is characterized as 80% in one eye and 40% in the other? The patient is a 65-year-old male who uses bifocal lenses. [ 01/15/09 ]
Estimates of the amount of vision loss based on optic nerve damage from glaucoma are difficult. Typically, glaucoma affects the peripheral vision. Some patients with glaucoma have vision loss very close to the center of vision instead of or in addition to vision loss peripherally. Because glaucoma can affect very specific portions of the optic nerve, specific areas of vision can be lost even with only mild damage to the overall nerve. Patients with central vision loss and only mild focal optic nerve damage might quantify their vision loss as severe as other patients with severe peripheral vision loss but preserved central acuity. To further understand what portions of the vision are affected, you should speak with your eye care provider and examine the visual field together. Can glaucoma cause a lump or tumor in the retina? [ 12/31/08 ]
Glaucoma does not cause a lump or tumor in the retina. However, some ocular tumors can be associated with “secondary glaucoma,” which means that the size or nature of the tumor is causing the glaucoma. My 16 year old daughter has had Stevens-Johnson syndrome since she was 12. She has been on prednisone and atropine eye drops, and she also uses over-the-counter Thera Tears to replace her normal tears. She had to have cataract surgery in both eyes last year. About 8 months ago, she developed ‘foggy vision.’ At first, it was only for a few minutes and then it would stop. Now, the symptom occurs every day and lasts all day long. Mostly, the fogginess occurs in her right eye, but occasionally both eyes are affected. She also says that she sees a rainbow around lights when her vision is foggy. Her eye pressure is normal according to her doctor. He says that the symptoms are from dry eyes; however, I don't think so. He also says there are no cataracts. I am considering changing doctors; however, I am not sure where to turn. Our options are limited because our insurance is Medicaid. I would appreciate your input. [ 12/31/08 ]
Intermittent blurring of the vision can be caused by numerous factors. Dry eyes can definitely cause foggy vision and glare symptoms. The severity of the symptoms can vary daily and each eye can be impacted differently. Intermittent high eye pressures can cause swelling of the cornea, and can result in colored haloes. However, these high eye pressures are usually associated with pain and light sensitivity. Clouding of the lens capsule that surrounds her lens implant can also cause blurred vision, but this condition should be fairly constant and diagnosable by routine examination. Chronic steroid use can be associated with steroid-induced glaucoma, which would be detected clinically by elevated eye pressures and signs of optic nerve dysfunction. Your daughter's eye condition is complex, and a second opinion is never a bad idea. The majority of eye care providers accept patients with Medicaid insurance. EyeCare America, a program of the American Academy of Ophthalmology, can help you locate an eye doctor, if you would like to seek another opinion. Their number is 1-800-222-3937. I have open-angle glaucoma. Last night, my left eye started to go completely blind. The eye also became numb. I put my eye drops in and my vision came back. This scenario has happened a lot in the last few months. Are these symptoms caused by a stroke or is it more likely related to the glaucoma? [ 12/31/08 ]
Your symptoms are very concerning. Transient loss of vision in one eye can be associated with poor cerebral blood flow and impending stroke (a condition known as amaurosis fugax). This type of transient vision loss is often described as a curtain or veil clouding the vision completely, and can happen to only one eye at a time. The glaucoma eye drops may improve blood supply to the optic nerve by lowering the eye pressure and allow the impaired blood circulation to better reach the optic nerve, which could possibly explain the improvement in your vision. You should speak to your eye doctor right away so that he/she can determine the nature of the transient vision loss. If it is determined that you are having transient ischemic attacks, you need evaluation immediately to reduce your risk for a major stroke. I have thyroid cancer and I am taking medication to suppress the disease. I recently have been told that my optic nerve is showing early signs of glaucoma even though my pressure readings are fine. Can hyperthyroidism impact the optic nerve and cause glaucoma? [ 12/31/08 ]
Thyroid disease can be associated with glaucoma, but the relationship between the two conditions is not well understood. Patients with thyroid-related eye disease (Graves’ ophthalmopathy) can develop glaucoma in relation to the compression of the eye and optic nerve by the enlarged extraocular muscles. This type of glaucoma is usually associated with increased eye pressure. In your case, the eye pressures are not markedly elevated, yet your doctors are indicating that there are signs of glaucoma. In many major studies, 30-50% of patients with glaucoma have pressures that are considered "normal." My mother and sister both had glaucoma. Two years ago, my eye pressure was 21. My doctor performed more definitive tests and said that I have an unusually shaped optic nerve and a very thick cornea; however, I did not have glaucoma. Last week, I saw another doctor and my eye pressure was 13. He said that I do have glaucoma, and that eye pressure readings can go up and down. I also have chronic major depression and have read that the most commonly used eye medication causes depression to worsen, which concerns me a great deal. Which doctors’ advice should I follow? How should I address the eye drops and their connection to depression? Should I obtain another opinion? [ 12/31/08 ]
You have stated two definite risk factors for having glaucoma: a family history of glaucoma and fluctuating eye pressure. It appears that several years ago, your doctor did not feel that you had developed signs of glaucoma. Namely, he determined that your true eye pressure was lower than 21 based on the fact that you have thick corneas, and that your optic nerve appeared healthy when he tested its structure and function. Corneal thickness does influence the accuracy of the measurement of intraocular pressure. Your most recent eye pressure reading of 13 with signs of glaucoma is concerning. Patients with glaucoma can have large fluctuations in the eye pressure. To make a diagnosis of glaucoma, detection of optic nerve dysfunction either with visual field testing or optic nerve head imaging is necessary. You should ask your doctor how he made the diagnosis of glaucoma. Obtaining another medical opinion from a board certified eye doctor is never a bad idea, and bringing old records to your appointment is vital to an accurate assessment of your eye health. Search for a Question
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Disclaimer: The information provided in this section is a public service of the American Health Assistance Foundation, and should not in any way substitute for the advice of a qualified healthcare professional and is not intended to constitute medical advice. Although we take efforts to keep the medical information on our website updated, we cannot guarantee that the information on our website reflects the most up-to-date research. Please consult your physician for personalized medical advice; all medications and supplements should only be taken under medical supervision. The American Health Assistance Foundation does not endorse any medical product or therapy. Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information. Last Reviewed On: 09/11/09 |
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