Shroff Eye Hospital

Qts.: A few weeks ago, my Dad had some laser done on both his eyes, to prevent glaucoma ever coming in the future, as my Dads brother has glaucoma. Yesterday my Dad went back to the laser eye doctor, to get one final blast of the laser done in his second as my Dad has brown eyes and so he had to go twice as the eye doctor said that brown eyes are a bit thicker than normal colored eyes. When my Dad got there, the eye doctor measured the pressure in my Dads eyes and he said it was a bit high. My Dad is worried now about why the pressure in his eyes was a bit high. My Dad is sick with a bad virus at the moment, and he is coughing all day and he feels sick and he is on antibiotics for it but he is still sick with it. Could that be why the pressure in his eyes was up that day do you think? Also, my Dad was wondering, if someone had glaucoma and they didn't know it and they didn't get any treatment at all for it, how long would it take for the person to go blind?

Ans.: Yes, the IOP can rise transiently after the laser, this is only temporary. A cold and increase in pressure can also be related mildly to coughing and the strain of the same. To know one's status of eye and prognosis of the same, one needs to know what is the status of his/her visual field, optic nerve status and how well responsive is the glaucoma to treatment. If all good, then there is no need to worry so long as one is careful. Please read more about glaucoma on www.shroffeye.org.

Qts.: I wrote to you recently about how my Dad was going to have some laser done on both his eyes, to prevent him from ever getting glaucoma as his older brother has glaucoma, and my DAd had narrow angles or something like that. My Dad has finished having the laser done now, and he is really happy. My Dad was just wondering if that is okay forever now, or if the treatment will have to be repeated at some stage later on, to keep being effective in preventing glaucoma. My Dad is 74 years old?

Ans.: I am glad that you father is doing well. He should just keep a check on his IOP or eye pressure on a regular basis. Follow simple tips how to keep the pressure at bay. Please read more about Glaucoma on www.shroffeye.org. Yes, he can undergo the laser treatment again, but is rarely needed to be repeatedly performed. The laser may be repeated when necessary and 2 weeks is good enough time as a gap. So long as his eye pressure is in control, this can even be planned later. There is nothing that undoes what laser treatment was applied the first time. Your examining doctor would be able to tell you if any urgent treatment is necessary or not.

Qts.: My primary care physician suggested I have a "diabetic eye exam" because I have diabetes. The first time I went to the ophthalmologist he tested my pressure, among other things, and told me to come back in 3 weeks so he could test it again. I did this, and now he is telling me I need an iridotomy in both eyes. He said it would only take 10 minutes and I would be able to drive myself home. He also said the only side effects would be a "sore eye for a little while". He wanted me to do it almost immediately; like 2 days later. From everything I am reading on the internet, people are warning against it. They say they have white lines in their line of vision, blind spots, worsened vision, double vision flashing lights and red, sore eyes that won't get better. I have also read on several websites that you need to bring someone with you because you won't be able to drive immediately after the surgery. I am frightened out of my wits and am having second thoughts. Is everything I'm reading true? Can all of these things happen? And will I be able to drive myself home?

Ans.: Iridotomy is not an uncommon procedure and also not such a major one which threatens sight. Any eye procedure will alter vision temporarily till healing is completed. You must however understand and ask the doctor why he has ordered this procedure? Is it because of raised eye pressure, as diabetes usually affects the retina and iridotomy is done in another anatomical part of the eye. Do not fear the procedure, but understand its indication, that will help you keep a check on your eye condition.

Qts.: Doctor says I need an iridotomy because the pressure in my eyes is too high. One part of the eye is too close to the other part (I don't remember the names-but he did mention the iris) and therefore the channel through which the viscous fluid drains is almost non-existent. Does this sound righ?

Ans.: Yes that is the usual line of treatment. This needs to have a regular check on the IOP on your part, as this means that you have a condition called 'Glaucoma' and it may be 'closed angle type' where medications may not open the channel. If still in doubt, take another opinion with a glaucoma specialist. You may read more about glaucoma on www.shroffeye.org.

Qts.: They say I need to have a whole shoot through each iris using lazer treatment to prevent glaucoma?

Ans.: This is usually a laser iridotomy, to allow a flow of the fluid in the eye, through this passage if the eye pressure is high due to blockage of the channels near the iris (which causes glaucoma). It is routinely done. In the hands of an expert you should be fine. Make sure that the centre you are visiting has a Glaucoma specialist who will look after your case.

Qts.: My uncle is suffering from glaucoma and he says there is no treatment because this disease should be controlled in its early stage and that stage has gone, is there any treatment available in any country.

Ans.: Of course there is treatment and the earlier it starts to affect the eyes, the better it is for vision. Loss of vision cannot be reversed.

Qts.: I had an iridotomy performed (Yag laser) on my right eye as a prevention for developing narrow angle glaucoma. Much to my surprise, the procedure was extremely painful - beyond description (and I have a very high pain threshold)! My ophthalmologist said it was the first time he had ever had a patient actually able to feel the laser but offered no explanation for why it was so painful. The eye was numbed with drops prior to the procedure and the pain started after the first two laser shots. Do you have any idea what could cause this? I am scheduled to have the left eye done next week and have decided to not proceed unless I can understand why and have some idea how to mitigate a possible repeat of the pain during the left eye procedure.

Ans.: Yes, there is a certain amount of discomfort during the laser shots in spite of the anesthesia drops as it is a large energy pulse. You may speak with your treating doctor and consider taking painkillers afterwards if needed. Usually this is not described as pain but discomfort.

Qts.: I had iridotomies done to both my eyes 14 months ago because of narrow angles. I am still having severe inflammation; my eyes are red and very sore. Besides I have some visual disturbances: I see a bothersome white line in the middle of my vision, I see every object twice, as if there was a ghosting image and I also notice strange flashes of light. My visual acuity has dropped from 20/20 to 20/80 in my left eye and from 20/25 to 20/100 in my right eye. Do you think there is still some hope for me?

Ans.: It may not be the procedure (iridotomy) which caused this, although the timing could be coincidental.Usually loss of vision or drop in the same maybe in your case could be due to the narrow angle Glaucoma itself. It would be best to be under the supervision of a Glaucoma specialis.

Qts.: The drop in vision and the other visual aberrations occurred immediately after the surgery. Unfortunately I had both eyes done the same day. The inflammation and the drop in vision started immediately. My husband drove me home and when we arrived I could hardly see anything. The inflammation was worse the next morning and became a tiny bit better after I had taken lots of steroids during the next weeks. But the eyes are still very red and very, very sore. My vision never returned to normal. I had almost perfect vision when it was checked immediately before the iridotomies, it was 20/20 and 20/25. Besides, why should my vision drop AFTER the iridotomies which were done to prevent vision loss? My angles are open now. I am under the supervision of a glaucoma specialist, and he told me the problems I am having are without any doubt due to the iridotomies. It is not uncommon that some eyes react to the surgery as mine do. Do you think I might eventually be able to improve my vision and get rid of the inflammation? My ophthalmologist is at a loss what to do.

Ans.: Please get the retina checked since sometimes due to the YAG laser when too much power is used, can cause retinal detachment. Now that the iridotomies are done, please ask for a dilated eye check to rule out a retinal pathology and another possibility is the starts of a cataract again because of the high power of YAG. It could be a retinal edema as well, better to show a retinal specialist.

Qts.: My mother has glaucoma for the last 10 years and she has lost her sight in 1 eye and the vision in the second eye is gradually decreasing, in spite of taking different drops on a regular basis, and now it has dropped to about 20% vision. Any advice.

Ans.: She definitely needs the attention of a good glaucoma specialist who can stop the deterioration of vision as we know the cause to be Glaucoma and now this filed has many new eye drops and advances in treatment. Take an opinion from glaucoma specialist close to your location.

Qts.: I was recently diagnosed with the start of glaucoma, and was told I was a good candidate for laser surgery if I had ever thought of having it done. However I didn't ask to many questions because of the price of the surgery. But I would like to know if having laser surgery would help stop the glaucoma from progressing. I can't stand the thought of going blind.

Ans.: Presuming that this laser that you speak of is to treat Glaucoma, this is called SLT. Some have benefited from this procedure that they do not need to use any more eye drops, for others it has been a reduction in the number of eye drops, few it has not benefited, but not complicated anything either. The eligibility criteria are clearly defined and if your doctor thinks that you will benefit for this procedure, you may go ahead.

Qts.: I have had bilateral laser iridotomy for narrow angle glaucoma. Is it safe to have your eyes dilated after you have had this procedure or is this why the procedure is done, so that you can have your eyes dilated.

Ans.: The eye doctor decides to dilate or not dilate when you visit his office and the eye pressure is checked. Yes, we have dilated some patients using a short acting dilating eye drop and not repeating the use of the same to hasten the dilation. However, please let your optometrist/ ophthalmologist take this call.

Qts.: My mom, aged 70 yrs is suffering from glaucoma, diabetes & hypertension. Though she is using drops for the eyes, her eyesight is weakening day by day. Is there any surgical process through which her vision can be restored?

Ans.: Your mother does have eye problems which need to be managed by specialists. Yes, an eye report would help. Glaucoma can be controlled well with eye drops, but if any vision has already been lost due to Optic nerve damage, then this loss is not reversible. Also, diabetes if not in control can damage the retina again resulting in visual loss. An eye report outlining her retinal condition and other tests can help me suggest better.

Qts.: Having been diagnosed last year with glaucoma I am on daily Xalacom drops which are controlling the pressure well. Yesterday I went for laser treatment. Because I have very dark brown eyes the Dr was unable to penetrate my iris in each eye beyond 25%. He has told me it is possible to try again later in a few weeks. In your opinion is it possible for this to work or is there an alternative route

Ans.: YAG Iridotomy helps for Closed angle Glaucoma. We see Asian eyes all the time as we are based in india and almost all of them have dark brown irises, this has not come in the way of our treatments. In any case, there is no harm if he has called you in at a later date.

Qts.: My father is having glaucoma from last one year, in his right eye. one of the leading doctor from Jammu India had done operation on his right eye five months before. Now my father has lost the vision of his right eye. Will u suggest me what we do next for recovery?

Ans.: Sadly, in Glaucoma, if not under control it affects the optic nerve and can damage the vision permanently. The loss of vision if due to this is then irreversible. Please send us the exact report that the eye doctor has written regarding the condition of his optic nerve, his visual acuity (6/36 etc)

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