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Suggest Treatment For Open Angle Glaucoma
Question: My aunt has been suffering from with open angle glaucoma for several years. She has been treating it with a combination of eyedrops. She also takes vitamins and supplements for eye health. Her eye pressure however has been within the normal range.
An eye test done was done last week, indicated that her nerves and eyesight are severely damaged. I could attach the detailed scans of both her eyes.
I was wondering what could be the best treatment under these circumstances. Could eye surgery be a recommended solution for improving/preserving her eyesight?
Patient, 83 years old, suffers from partially obstructed carotid in the neck and occasional high blood sugar during the last year or so.
I would really appreciate an opinion on this.
Thank you.
An eye test done was done last week, indicated that her nerves and eyesight are severely damaged. I could attach the detailed scans of both her eyes.
I was wondering what could be the best treatment under these circumstances. Could eye surgery be a recommended solution for improving/preserving her eyesight?
Patient, 83 years old, suffers from partially obstructed carotid in the neck and occasional high blood sugar during the last year or so.
I would really appreciate an opinion on this.
Thank you.
Brief Answer:
Please provide further information.
Detailed Answer:
Hello. Madam.
I have worked through your query in detail
Before guiding you further, I would like to know the following.
1.Is she experiencing gross visual deterioration of late?
2.Is there any associated symptoms like Headache or coloured halos?
3.Apart from RNFL test, did she undergo any other additional tests?
Once I receive your answers, I will guide you further.
Thank you.
Please provide further information.
Detailed Answer:
Hello. Madam.
I have worked through your query in detail
Before guiding you further, I would like to know the following.
1.Is she experiencing gross visual deterioration of late?
2.Is there any associated symptoms like Headache or coloured halos?
3.Apart from RNFL test, did she undergo any other additional tests?
Once I receive your answers, I will guide you further.
Thank you.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hello doctor,
Yes, she is experiencing gross vidual deterioration, particularly in the last two months or so, accompanied with occasional headaches and halos.
She underwent another eye test as well, and I have the reports, but that file format cannot be attached here in the website. Could you please give me your email address where I can send them?
Many thanks
Hello doctor, just a correction I wanted to make, she does not see halos around objects and has no headaches.
Thank you.
Yes, she is experiencing gross vidual deterioration, particularly in the last two months or so, accompanied with occasional headaches and halos.
She underwent another eye test as well, and I have the reports, but that file format cannot be attached here in the website. Could you please give me your email address where I can send them?
Many thanks
Hello doctor, just a correction I wanted to make, she does not see halos around objects and has no headaches.
Thank you.
Brief Answer:
Surgery cannot improve vision
Detailed Answer:
Hello, Madam.
In presence of deteriorating vision, the outcome of surgery can be poor.
There can be few drugs that can slow down macular edema of the left eye.
Considering the RNFL analysis, the nerves if retina seem to be severely and grossly damaged in both the eyes (Right>Left).Send your reports to YYYY@YYYY in case you find difficulty in uploading them.
Under this preview, eye surgeries for Glaucoma will not yield results as you would have liked.
I request you to consult your Opthalmologist for drugs that can slow down macular edema.
Post your further queries if any.
Thank you.
Surgery cannot improve vision
Detailed Answer:
Hello, Madam.
In presence of deteriorating vision, the outcome of surgery can be poor.
There can be few drugs that can slow down macular edema of the left eye.
Considering the RNFL analysis, the nerves if retina seem to be severely and grossly damaged in both the eyes (Right>Left).Send your reports to YYYY@YYYY in case you find difficulty in uploading them.
Under this preview, eye surgeries for Glaucoma will not yield results as you would have liked.
I request you to consult your Opthalmologist for drugs that can slow down macular edema.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you.
I have heard of anti-VEGF medications injected directly in the eye to treat macular edema, can prevent advancement of the disease, and also improve vision in patients some of whom even declared legally blind.
Can such treatment yield some hope for even a small vision improvement in my aunt's case?
I have heard of anti-VEGF medications injected directly in the eye to treat macular edema, can prevent advancement of the disease, and also improve vision in patients some of whom even declared legally blind.
Can such treatment yield some hope for even a small vision improvement in my aunt's case?
Brief Answer:
Anti VEGF is a promising therapy.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
Yes, indeed Anti VEGF medications given intravitreally will improve the vision and prevent worsening of Macular edema.
Definitely, this is a hope for vision improvement .
These treatments are offered only at expert and sophisticated hospitals.
Post your further queries if any.
Thank you.
Anti VEGF is a promising therapy.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
Yes, indeed Anti VEGF medications given intravitreally will improve the vision and prevent worsening of Macular edema.
Definitely, this is a hope for vision improvement .
These treatments are offered only at expert and sophisticated hospitals.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thank you doctor!
What intraocular injections may be available at hospitals as alternative to anti VEGF medications, and are they effective for improving vision in macular edema patients?
Do you think that my aunt gas glaucoma in her left eye as well, or only in her right eye?
Best regards.
What intraocular injections may be available at hospitals as alternative to anti VEGF medications, and are they effective for improving vision in macular edema patients?
Do you think that my aunt gas glaucoma in her left eye as well, or only in her right eye?
Best regards.
Brief Answer:
DEXAMETHASONE can be an alternative
Detailed Answer:
Hello, Madam.
Yes, as per the reports, there is Glaucoma in both the eyes.
Drugs alternative to intravitreal Anti VEGF are available.
Drugs particularly Intravitreal DEXAMETHASONE or TRIAMCINALONE will help to prevent macular edema and improve vision.
Please check with your physician if he shares my view and if can prescribe these drugs.
Post your further queries if any.
Thank you.
DEXAMETHASONE can be an alternative
Detailed Answer:
Hello, Madam.
Yes, as per the reports, there is Glaucoma in both the eyes.
Drugs alternative to intravitreal Anti VEGF are available.
Drugs particularly Intravitreal DEXAMETHASONE or TRIAMCINALONE will help to prevent macular edema and improve vision.
Please check with your physician if he shares my view and if can prescribe these drugs.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you again doctor.
Shall the injections be given in both eyes, or only in the leftt eye?
The patient took a short distance flight about one month ago. Could this air travel have influenced in causing/worsening the macular edema?
Shall the injections be given in both eyes, or only in the leftt eye?
The patient took a short distance flight about one month ago. Could this air travel have influenced in causing/worsening the macular edema?
Brief Answer:
Injections should be given in the left eye only.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
Anti VEGF injections have to be specifically given only in the eye affected by clinically significant macular edema.In her case , it will be the left eye.
Macular edema rarely gets affectfd by flight travel.
Post your further queries if any.
Thank you
Injections should be given in the left eye only.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
Anti VEGF injections have to be specifically given only in the eye affected by clinically significant macular edema.In her case , it will be the left eye.
Macular edema rarely gets affectfd by flight travel.
Post your further queries if any.
Thank you
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Many thanks doctor!
As promised, I have just sent you via email the two additional eye scans that I could not save in the website. Please let me know if they help in diagnosing better.
Are intravitreal DEXAMETHASONE or TRIAMCINALONE, Anti VEGF medications? Or do they fall under a different category? For how long are they usually used?
Best regards.
As promised, I have just sent you via email the two additional eye scans that I could not save in the website. Please let me know if they help in diagnosing better.
Are intravitreal DEXAMETHASONE or TRIAMCINALONE, Anti VEGF medications? Or do they fall under a different category? For how long are they usually used?
Best regards.
Brief Answer:
Both drugs belong to same class of Steroids.
Detailed Answer:
Hello, Madam.
I have worked through your attached reports in detail.
They all support the diagnosis of Glaucoma with severe nerve damage.
A single injection of TRIAMCINALONE is usually given which will have its effect for 6-9 months.
Both DEXAMETHASONE and TRIAMCINALONE fall under same category of drugs.Both belong to class of intravitreal Steroids.
A single injection is usually improves vision for 6-9 months.A second injection can be repeated after this period.
Post your further queries if any.
Thank you.
Both drugs belong to same class of Steroids.
Detailed Answer:
Hello, Madam.
I have worked through your attached reports in detail.
They all support the diagnosis of Glaucoma with severe nerve damage.
A single injection of TRIAMCINALONE is usually given which will have its effect for 6-9 months.
Both DEXAMETHASONE and TRIAMCINALONE fall under same category of drugs.Both belong to class of intravitreal Steroids.
A single injection is usually improves vision for 6-9 months.A second injection can be repeated after this period.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Many thanks doctor!
With the extent of her nerve damage in the left eye, how much improvement of sight may we expect after the intravitreal injections?
Are there any side effects of these injections, that we shall be aware of?
Which of the drugs may cause less side effects?
Best regards.
With the extent of her nerve damage in the left eye, how much improvement of sight may we expect after the intravitreal injections?
Are there any side effects of these injections, that we shall be aware of?
Which of the drugs may cause less side effects?
Best regards.
Brief Answer:
Side effects are very few
Detailed Answer:
Hello Madam.
I can understand your concern.
The side effects are relatively very few.
Vision improvement can be significant.This can be measured on Snellen's Visual charting only.
Intravitreal TRIAMCINALONE can have very less side effects.
Vision improvement in the left eye can be more, where as in the right eye is questionable.
But nevertheless, vision is significantly improved in various clinical trials with Anti VEGF agents.
Post your further queries if any.
Thank you.
Side effects are very few
Detailed Answer:
Hello Madam.
I can understand your concern.
The side effects are relatively very few.
Vision improvement can be significant.This can be measured on Snellen's Visual charting only.
Intravitreal TRIAMCINALONE can have very less side effects.
Vision improvement in the left eye can be more, where as in the right eye is questionable.
But nevertheless, vision is significantly improved in various clinical trials with Anti VEGF agents.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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