Science & Research

Hearing loss can be caused by various factors, including chronic exposure to loud noises, conditions that affect the noise conduction of the ear itself (ear infections, otosclerosis), some systemic infections (mumps, meningitis), cancer, and endocrine disorders (diabetes, thyroid disease), for example. Glaucoma is a progressive condition where there are characteristic patterns of visual loss that result from damage to the optic nerve. This damage is related to elevated eye pressure and other factors. There are some types of glaucoma that have been shown to be associated with increased incidence of hearing loss. These include pseudoexfoliative glaucoma, glaucoma associated with congenital rubella infection, glaucoma associated with congenital abnormalities of the anterior segment of the eye, and some cases of normal-tension glaucoma.

Trabeculectomy surgery involves the creation of an outflow pathway from the anterior chamber of the eye to the outer surface of the eye. The result is a filtering bleb that functions to lower the eye pressure. This outpatient surgery typically takes approximately an hour to complete, and is performed under local anesthesia. The recovery period usually lasts approximately 6 weeks. At the beginning of this period, limitations of activity are advised for 1 - 2 weeks (no lifting of objects greater than ten pounds, no straining, and no bending below the waist, for example). An eye shield or protective glasses must be worn. Frequent administration of eye drops is required initially (every 2 - 4 hours), and then medications are gradually tapered off. The vision can fluctuate dramatically in the first 4-6 weeks after surgery, but usually stabilizes by the sixth week. The surgeon typcially will examine the patient the first day after surgery, and every 1 - 2 weeks thereafter for the first month. During these visits, modifications of the healing trabeculectomy may be made, including suture removal and injections of anti-scarring medications. This recovery period is similar for patients of all ages.

Memantine is a drug that is under investigation for its neuroprotective qualities in patients with glaucoma. A recent clinical trial did not show that this drug reduces the progression of glaucoma damage in humans. However, data from animal studies suggests that there is potential of this drug and other similar drugs in the treatment of glaucoma. Currently, until more research is performed, memantine is not being prescribed for the prevention of glaucoma progression.

Your wife's symptoms characterize what is known as "bleb dysesthesia," where the filtering bleb causes discomfort and irritation. Many patients with this condition have improved symptoms with the use of artificial tears or topical non-steroidal anti-inflammatory agents such as Acular. In patients with continued symptoms despite topical medications, a surgical revision of the trabeculectomy is possible for increased comfort. A bleb leak can also cause increased tearing, but rarely causes discomfort. In order to maintain her present level of vision, maintenance of a stable range of pressures (where there is no further glaucoma damage as detected by visual field testing and optic nerve examination) is required. You should speak with your eye care provider about your concerns and options for treatment.

Your father needs to see an eye doctor immediately for an examination. Redness, intermittent pain, and decreased vision can be a result of many eye conditions, including dry eye, iritis, uveitis, narrow-angle glaucoma, surface infections, and other conditions.

Diphenhydramine, the active ingrediant in the antihistamine Benadryl, is safe for patients with open-angle glaucoma. Antihistamines should be used with caution in patients with narrow-angle glaucoma. This class of medications can increase the risk of a narrow-angle attack in patients with occludable angles who have not undergone a preventive peripheral iridotomy procedure. Your eye doctor can provide you with more details about this topic.

The filtering bleb that results from trabeculectomy surgery can change in size over time. These areas of thin conjunctiva that filter the eye fluid can become larger and start to overhang the cornea. This may cause some to patients experience ocular irritation and blurred vision, and may require surgical revision to relieve these symptoms. You should most certainly see your eye care provider earlier than your scheduled appointment if you experience any pain, decreased vision, redness, or abnormal discharge from the eye, as these symptoms may indicate an infection. It would be prudent to at least contact your eye doctor to update him/her about the symptoms that you described in your question.

Marijuana derivatives taken orally, intravenously, or by smoking do lower the eye pressure briefly. The active ingredient does not cause reduction of eye pressure when administered in an eye drop formulation. The effects of marijuana are brief, lasting only hours, and are thus not suitable for long-term eye pressure control. Because marijuana can also reduce blood pressure briefly, it may be associated with reduced blood supply to the optic nerve, which could adversely affect patients with glaucoma. Thus, medical marijuana is not recommended in the treatment of glaucoma.

The role of emotional and mental stress in the onset and progression of glaucoma is not well understood and is very difficult to study. The best way to prevent further vision loss in glaucoma is to reduce the eye pressure to a stable range with medications, laser therapy, or glaucoma filtering surgery. Glaucoma that affects young adults is uncommon, and is known as juvenile onset glaucoma. Evaluation by a glaucoma specialist is recommended to best determine the severity of the disease and options for management.