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Suggest Treatment For Glaucoma In Both Eyes While On Treatment With Pilocar 2%, Simbrinza And Lumigan 0.01%
Question: During a routine eyesight check-up my father Mr. L.K.Mathur's was diagnosed with Glaucoma in both eyes and have been regularly visit an eye specialist in this regard since 18/06/2017.
Following tests have been done so far and copy is attached
1. Doctor consultation and observation summary (prescription since 18/06/2017 - till date)
2. Fields test 10-2 both eyes on 23-04-2018
3. Fields test 10-2 both eyes on 20-06-2018
4. OCT - RNFL on 19-06-2017
5. Pachy on 19-06-2017.
Medicines:
Lumigan 0.01% - Once daily, 10:45 PM
Simbrinza - Twice daily, morning 9AM and Evening 9 PM
Pilocar 2% - Thrice daily, starting 24-04-2018
May I kindly request you to go through the reports and medicines and suggest your opinion/suggestions.
Thanks & Regards,
Ankit
Following tests have been done so far and copy is attached
1. Doctor consultation and observation summary (prescription since 18/06/2017 - till date)
2. Fields test 10-2 both eyes on 23-04-2018
3. Fields test 10-2 both eyes on 20-06-2018
4. OCT - RNFL on 19-06-2017
5. Pachy on 19-06-2017.
Medicines:
Lumigan 0.01% - Once daily, 10:45 PM
Simbrinza - Twice daily, morning 9AM and Evening 9 PM
Pilocar 2% - Thrice daily, starting 24-04-2018
May I kindly request you to go through the reports and medicines and suggest your opinion/suggestions.
Thanks & Regards,
Ankit
Brief Answer:
surgery like trabeculectomy is to be considered rest is alright.
Detailed Answer:
Protectiveness like a dark room and water drinking test can be done.Surgery like trabeculectomy can be considered.If pressure still goes up then it can be controlled by tablet diam-ox.Continuous monitoring by taking IOT be done.The investigation, as you have rated, are to be repeated.Consult glaucoma specialist for the second opinion.Regarding treatment fundus examination to be done and disc and fovea ratio to be measured.Tubular vision is the ultimate outcome.It is due to peripheral detachment of retina so it is to be looked into.Holes and tear and detachment can be observed. Use of pilocarpines frequency is to be reviewed. All other test and investigation and medication are alright except a review of pilocarpine. A tenelol drop will be a better substitute
surgery like trabeculectomy is to be considered rest is alright.
Detailed Answer:
Protectiveness like a dark room and water drinking test can be done.Surgery like trabeculectomy can be considered.If pressure still goes up then it can be controlled by tablet diam-ox.Continuous monitoring by taking IOT be done.The investigation, as you have rated, are to be repeated.Consult glaucoma specialist for the second opinion.Regarding treatment fundus examination to be done and disc and fovea ratio to be measured.Tubular vision is the ultimate outcome.It is due to peripheral detachment of retina so it is to be looked into.Holes and tear and detachment can be observed. Use of pilocarpines frequency is to be reviewed. All other test and investigation and medication are alright except a review of pilocarpine. A tenelol drop will be a better substitute
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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