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How Can Near Sighted And Dry Eyes Be Treated?
Question: Dear Doctor,
37 year old male in pretty good health overall (don't smoke/drink moderately/exercise regularly/try to eat healthy, though I am overweight/obese). I also take several supplements approved by my doctor/nutritionist (garlic, fish oil, whole food multi, cayenne, tumeric, etc.).
I didn't have an eye doctor appointment for 2-3 years as my doctor moved and I just hadn't found a new one. I'm pretty nearsighted (O.D. -6.00 spherical with +0.75 cylindircal at 70 degree axis; O.S. -6.75 spherical) and I also have chronic dry eye. Plugs were tried but fell out, Restasis was tried for a while, but now I'm just using natural tears several times a day as they seem to work as well as anything (and I'm doing okay with it).
Anyways, my new eye doctor today did a much more thorough exam than I've ever had in the past. I really wasn't expecting any issues and was surprised when he told me I had an enlarged retinal nerve, and that put me at risk for glaucoma, so I have to followup with some additional tests next month, then see him again in another month. I did find out my pressures were 19 in one eye and 18 in the other (and from looking it up, <22 is considered normal?)
He had mentioned that enlarged retinal nerves can stay the same for a lifetime or they can worsen over time. No doctor before has ever mentioned this to me. He told me not to lose sleep over it (and that he thinks I probably won't test positive for glaucoma yet but will need to monitor yearly for it), so I'm trying not to overly worry, but I am concerned and had a few questions.
I do have a family history of glaucoma. My mom has it, though she's 71, it's under control, and she still can see well. (I think my grandparents had it too.)
1.) Is this likely genetic and previous doctors just didn't see it or bring it up to me, or could this finding be new?
2.) Does enlarged mean *inflamed*, or simply a bigger structure than normal? I take several supplements to try to combat inflammation, and systemic inflammation is a concern for me (particularly to combat heart/blood vessel disease), so I wanted to clear this up.
3.) Could anything I'm doing or supplements (mostly whole foods, spices, etc.) contribute to this, or is it likely just something that would have happened no matter what?
4.) If normal is <22, is 18 and 19 for my eyes at this time okay?
Anything else you can tell me as far as how risky this is would be helpful.
Thank you!
37 year old male in pretty good health overall (don't smoke/drink moderately/exercise regularly/try to eat healthy, though I am overweight/obese). I also take several supplements approved by my doctor/nutritionist (garlic, fish oil, whole food multi, cayenne, tumeric, etc.).
I didn't have an eye doctor appointment for 2-3 years as my doctor moved and I just hadn't found a new one. I'm pretty nearsighted (O.D. -6.00 spherical with +0.75 cylindircal at 70 degree axis; O.S. -6.75 spherical) and I also have chronic dry eye. Plugs were tried but fell out, Restasis was tried for a while, but now I'm just using natural tears several times a day as they seem to work as well as anything (and I'm doing okay with it).
Anyways, my new eye doctor today did a much more thorough exam than I've ever had in the past. I really wasn't expecting any issues and was surprised when he told me I had an enlarged retinal nerve, and that put me at risk for glaucoma, so I have to followup with some additional tests next month, then see him again in another month. I did find out my pressures were 19 in one eye and 18 in the other (and from looking it up, <22 is considered normal?)
He had mentioned that enlarged retinal nerves can stay the same for a lifetime or they can worsen over time. No doctor before has ever mentioned this to me. He told me not to lose sleep over it (and that he thinks I probably won't test positive for glaucoma yet but will need to monitor yearly for it), so I'm trying not to overly worry, but I am concerned and had a few questions.
I do have a family history of glaucoma. My mom has it, though she's 71, it's under control, and she still can see well. (I think my grandparents had it too.)
1.) Is this likely genetic and previous doctors just didn't see it or bring it up to me, or could this finding be new?
2.) Does enlarged mean *inflamed*, or simply a bigger structure than normal? I take several supplements to try to combat inflammation, and systemic inflammation is a concern for me (particularly to combat heart/blood vessel disease), so I wanted to clear this up.
3.) Could anything I'm doing or supplements (mostly whole foods, spices, etc.) contribute to this, or is it likely just something that would have happened no matter what?
4.) If normal is <22, is 18 and 19 for my eyes at this time okay?
Anything else you can tell me as far as how risky this is would be helpful.
Thank you!
Brief Answer:
Glaucoma should be treated with drops tablet or surgery like trabeculectomy
Detailed Answer:
Hello,
Carry out the test if advised maintaining it is OK between 18 to 22. If uncontrollable then medication like a tynalol drop or oral Diamox can be taken.
Surgery like trabeculectomy can be considered. It is to be decided with advice of treating doctor. It is not genetically transmitted, dark room test and water drinking test to induce high pressure can be done. gonioscopy and slit lamp examination be done to asses the angle.
At times there is wide angle glaucoma which can be controlled by medication and surgery. Fundus examination in which disc macula proportion to be assessed. Field tracing should be done to exclude thyroiditis.
It can be hypo or hyperthyroidism and immunologist can be consulted and advise can be taken for treatment. Glaucoma should be treated or else it will lead to tubular vision. This will restrict the field.
Hope I have answered your query.
Take care
Regards,
Dr Ashok Kumar Dash, Ophthalmologist
Glaucoma should be treated with drops tablet or surgery like trabeculectomy
Detailed Answer:
Hello,
Carry out the test if advised maintaining it is OK between 18 to 22. If uncontrollable then medication like a tynalol drop or oral Diamox can be taken.
Surgery like trabeculectomy can be considered. It is to be decided with advice of treating doctor. It is not genetically transmitted, dark room test and water drinking test to induce high pressure can be done. gonioscopy and slit lamp examination be done to asses the angle.
At times there is wide angle glaucoma which can be controlled by medication and surgery. Fundus examination in which disc macula proportion to be assessed. Field tracing should be done to exclude thyroiditis.
It can be hypo or hyperthyroidism and immunologist can be consulted and advise can be taken for treatment. Glaucoma should be treated or else it will lead to tubular vision. This will restrict the field.
Hope I have answered your query.
Take care
Regards,
Dr Ashok Kumar Dash, Ophthalmologist
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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