Barry wrote:
I am 75 yrs old and have been weight training 30yrs. I recently read that this activity is not recommended for those either suffering with glaucoma, or in a high risk category of developing glaucoma. If such be the case would one have to forgo weightlifting or could they continue with a modified program. What sort of weight bearing exercises would be considered safe?

ANSWER

Dear Barry
Regular aerobic exercise has a beneficial effect on intraocular pressure and I would encourage you to add some aerobic activity to your exercise regimen if you are not engaged in this form of activity. Weight training has the potential to cause an elevation in intraocular pressure, especially if you are lying on your back and pushing weights with your legs elevated. When your legs are elevated, gravity will pull some of the blood in your legs “downhill” elevating the blood pressure in the rest of your body – including the veins around the eye. The aqueous fluid inside your eye eventually drains into the veins around your eye (after passing through a sieve-like filter called the trabecular meshwork). When the pressure in the veins around the eyes is elevated, it is more difficult for the aqueous to drain out of the eye. As a result, the pressure inside the eye (IOP) becomes elevated. To minimize the potential risks from weightlifting, it may be advisable to modify your weight bearing routine so that your head remains the uppermost part of your body when you are working out. It is also important to continue to breathe as normally as possible and not hold your breath when you are working out.  Holding your breath while you are pushing weights also elevates the pressure in the veins, making it more difficult for the aqueous to drain from your eyes.
Hope this is helpful.
Dr. Smit

Iva wrote:
Hello
My name is Iva and I’m writing to you because I’m concerned about my brother’s lazy eye. He is only 17. By lazy eye, I mean that his eye looks like Paris Hilton eye.
It has only been 2 years that he’s been wearing glasses. When we went to the doctor he told us that the number on the other eye was rising (from 0.3 to 0.5). He prescribed two medicines, Betoptic and another one. He told us that when my brother is 21 years old, he can have surgery. His vision on the right eye (the lazy one) now with the glasses is only 60%.
Please, I have so many questions…
Can the surgery wait until he is 21 years old?
What can we do now to protect the other eye?
Thank you for your time!

ANSWER

Iva,

It sounds like a few different issues.  The lazy eye, which you say looks like a Paris Hilton eye, I think, means that his eye is turning out.  This is generally caused by a problem with the eye muscles and can sometimes develop if the vision in that eye is significantly decreased.  The fact that the eye is turning out is mainly a cosmetic issue. Having surgery to straighten the eye muscles, will unfortunately not improve the vision in that eye.  Therefore waiting to have surgery to straighten the eye will not cause any further damage.  By the other information you have given me it sounds like he has glaucoma.  The numbers you gave (0.3-0.5) would be used to describe the optic nerves in the back of the eye.  This number represents the shape of the optic nerve. I am a little confused, but I think you mean that this number is changing in his good eye?  The medication they have prescribed is an anti-glaucoma medication. This will decrease the pressure inside the eye, which should stop the optic nerve numbers from changing. This will help to protect the good eye.  I understand that it can be very worrisome when someone in your family has serious eye problems.  Hopefully my answers have helped somewhat.

Dr. Doman

Nosrat wrote:
Dear Dr,
Re: Glaucoma
I have had gone through shunt eye surgery(Ahmed implant)in my both eyes. (2 months ago and Sept 5,2008)
My peripheral vision seem to me O.K as I can see vehicles passing by with my side vision at a distance of 50 feet on my both sides. Recently I have passed driving field test ,My surgeon told me that I am at an advanced stage of glaucoma. It started in 2002 with a very small blind spot in field test. My right vision is still 20/25 and left is 20/30.
I can read the finest print and can see No plates of moving cars (Eyes are not blurry)
I am noticing problem seeing closer things. Unless it is bright sun light or room light, I see faces a bit darker. The food sitting on my plate will not look sharp and crispy as before. It is hard to read book or write a page under normal room light I find very difficult to locate items in my drawer. I can watch T.V and work on my computer as their screens are lighted. My eyes are also very sensitive to light. I am using steroid drops after second Ahmed implant in my right eye on May 21, 2009. I am expected to phase out next month. Do you think my advanced glaucoma has created the aforesaid problems. Do you suggest any solution or I will have to live with this problem all my life? I am 63 old male. There is no cataract, no double vision, no blurry eyes, no color blindness, no advanced age macular degenerating.
I am very upset and depressed when faces look darker under normal room light or to eat food from my plate puts too much pressure on my eyes.
Thanks.
Sincerely yours,
Nosrat

ANSWER

Dear Nosrat
Glaucoma is often a difficult condition to control and it can lead to serious visual consequences. It is beyond the scope of this forum to adequately address the full scope of the visual changes you may experience as a result of this condition. It seems to me from your description, that it is most probable that some of your visual change that you describe is the result of your glaucoma. However, the fact that you experience more difficulties with your vision for near tasks than you do for seeing things in the distance suggests that there may have been a change in your refraction (glasses prescription) or your ability to accommodate (focus on near objects). It is normal for a person, even with healthy eyes, to lose their ability to focus their eyes up close as they go through their forties, and many people become more farsighted (or less nearsighted) in the decades that follow. This may explain why you are having more difficulties with your close up vision. I suggest that you see your optometrist to find out if a change in prescription might be beneficial.
Sincerely,
Dr. Smit

Ken wrote:
I am in my forties and have had Glaucoma all my life.  Over the years I have had 20 plus procedures in both eyes, and fortunately still see although I have lost about 80% peripheral vision.  The last 2 years my IOP has been a little higher than my doctor prefers.  During that time I get an extreme blurring of my visions every few seconds.  I had cataract surgery last year, however the symptoms persist.  I think my doctor thinks I am crazy and has no answers.  What could this be?

ANSWER

Hello Ken,
Because your visual field is so restricted, you may experience significant blurring from things that would go relatively unnoticed to a person with a normal field.  For example, dry eye can cause transient blurring which would improve with blinking or yawning.  If this is the culprit, then a simple artificial tear purchased over-the-counter would help to alleviate your symptoms.  I don’t believe that this blurring every few seconds is related to your Intra-Ocular Pressure (IOP).
I hope this helps,
Dr. Donati

Durango wrote:
I was recently diagnosed with pigmentary glaucoma. Travatan eye drops have successfully lowered my IOP. However, I have recently been diagnosed with depression and have been put on Cymbalta and Ritalin, yet I notice that both of these drugs don’t recommend use if the patient has been diagnosed with Glaucoma. Some web sites have suggested it may be ok if the IOP is successfully treated.

What is the real story behind anti-depressants and glaucoma?

ANSWER

Durango,
Side effects of medication are always a subject of concern because of potential damages. About your specific case, the only thing that I am aware of is anecdotical case reports linking the use of anti-depressants and a rare form of glaucoma (acute angle closure glaucoma). The authors suggest anti-depressants may have a direct action on the certain parts of the eye (Iris or Ciliary body muscle) through serotonergic or anti-cholinergic mechanisms, or both. This increases the risk to induce a closure of the angle between the iris and the cornea. Best thing to do is to ask the doctor who prescribed the glaucoma drug his opinion about the use of anti-depressants in your case. As it is always the case, prescribers should balance the pros and cons of each medication and to weight the benefits of adding a new drug compared with the potential risks associated with its regular intake. The second thing is to make regular follow-up visits at your optometrist or your ophthalmologist to measure the intra-ocular pressure.

Good luck,
Langis Michaud
Associate professor – U de Montréal

Pauline wrote:
Hi Doctor,

I just had an eye exam this morning and was told that I have glaucoma in my right eye and need a laser operation? They set me up an appointment on November 3rd 2009. She said it was not urgent and I can wait until then.

When she was doing the eye exam, she put this round thing with liquid in it, in my eye socket on the right side and a few seconds later I told her that it gave me a bad headache and she said she was sorry and that she may have put too much pressure on it and that she will be careful on the left side, which did not hurt. My eye exam was at 9am and it is now 6:30pm and I still have a major headache on the right temple and behind my right eye. My right eye is also very sensitive to light since this morning. I am 51 years old and my eyes are blue (extra information in case it makes a difference).

Is this normal? Should I be concerned? Please advise me what to do!
HELP!

Thanking you in advance,
Pauline

ANSWER

Pauline, it sounds like the Doctor used a special lens to examine the inside of your eye.  I hope that you were able to reach your Doctor so that she knows of your symptoms following the exam.  It may be necessary for her to perform the laser treatment sooner than November since you have had this reaction.

Dr. Joan Hansen, Optometrist for CAO

Cyril wrote:
I have glaucoma. My question is: My ophthalmologist dilates my eyes on regular visits. I would like to know what are the odds that having my eyes dilated will cause acute glaucoma attacks?

ANSWER

Cyril,

it is not at all common for dilation to cause an acute glaucoma attack. It is possible in certain eyes that have a different anatomy structure that crowds the iris into the area where the fluid drains from the eye.  This is referred to as a Narrow Angle. Your Ophthalmologist should know what your eye’s angle structure is like, and thus is not overly concerned about closing the angle and causing an acute glaucoma attack.  It is advantageous to dilate the pupil so that the doctor can see as much as possible inside your eye.  Should you have any new symptoms after dilation, it is always advisable to call the doctor immediately

Dr. Joan Hansen, Optometrist for CAO

Cheryl wrote:

Hi,
My son is 8 weeks old and occasionally he has bulging/prominent eyes, I have also noticed that he squints/blinks when we go outside.  I have an appointment with a pediatric optomologist next week.

I just wanted to know if these symptoms are occasional is there a reason to be concerned about glaucoma, or would these symptoms be constant?  Thanks, I’m just going to obsess about this until his appt.  Any input would be greatly appreciated!

Thanks,
Cheryl

ANSWER

Hi Cheryl,

By now you have likely been to the ophthalmologist and they will have given you accurate information.  I will do my best to answer your question, although it is extremely difficult without having seen your child.  The main signs of congenital glaucoma would be a hazy or cloudy cornea (clear surface, which covers the iris), excessive watering, extreme light sensitivity and squeezing of the eyelids.  Another sign is an eye that is larger than normal.  This would not be transient and is really hard to distinguish unless it is unilateral.  Your son does seem to be light sensitive because of squinting and blinking when he goes outside, but this is not uncommon in young children to a certain degree.  True light sensitivity would be when they are extremely sensitive to even normal levels of light (including inside) and would only open their eyes normally in dim lighting conditions.  Congenital glaucoma is very rare, with it affecting approximately 1 in 10,000 births.  The important thing is that you have by now already had his eyes examined. I hope this helps.

Dr. Carol Doman