Suggest Treatment For Scars And Pressure Sensation In The Eyes

Posted on Thu, 3 Nov 2016

Question: I need to chat with a eye specialist.My name is XXXXXXX I was born with scars behind my centre vision. My vision is 150/20 in my right eye and 100/20 in my left eye. I have high pressure (28) behind my eyes. The doctors cannot get it down. any ideas?

Answered by Dr. N K Mishra (1 hour later)

Brief Answer:
Anti glaucoma treatment

Detailed Answer:
My dear,
Thanks for sending your query to us.
There is a large number of eye drops to begin with,which can bring the pressure down easily.To start with as first line if treatment,Timolol o.5% eye drops twice a day should help.We are aiming at testing controllable conditions,rather than like the scar which you have,probably which can not be helped.Controlling pressure will reduce chances of further deterioration of vision.
Do get back to me in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. N K Mishra (1 hour later)

I have used numerous different kinds of drops prescribed by eye specialists and to date none have helped.

Answered by Dr. N K Mishra (4 minutes later)

Brief Answer:
Anti glaucoma drops

Detailed Answer:
My Dear,
Thanks for getting back to me.
Please send me the details of drops so I can finalize the suggestion.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. N K Mishra (58 minutes later)

I was using CombiGan 2x a day, and Travatan once a day, but neither helped so he told me to quit using these 2 and put me on Simbrinza 2x a day and DuoTrav PQ (Alcon) once a day and I'm also using 6 tablets a day of APO-Acetazolamide 250MG
After the cataract operation (to create more room)he also put me on ALrex 2x a day for one week after the operation. I was also on Tobramycin / Dexamethasone for 1 week after surgery.
Do you think a MRI would help to find out what the problem is, or where the problem is?

Answered by Dr. N K Mishra (18 hours later)

Brief Answer:
Glaucoma surgery may be a answer.

Detailed Answer:
My dear,
Thanks for providing these details.
In resistant cases like you,two or three drug region is usually sufficient.Oral anti glaucoma like Acetazolamide have limitations as prolonged oral use can lead to kidney stones.
Oral glycerine is what we use for short periods in cases like you.Next step is to have filtering surgery.Discuss these two modalities with your doctor and let us assess his opinion.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. N K Mishra (15 hours later)

I cannot get a appointment with my doctor for another week. (Oct 20th) would you be kind enough to keep the case open till then? I did speak to him briefly today and he agreed to put me on glycerine starting today. 55ml for 150 lbs body weight.

Forgot to ask, do you see any risk in glaucoma surgery?

Answered by Dr. N K Mishra (6 minutes later)

Brief Answer:
Control iop

Detailed Answer:
My dear,
it is of paramount importance to keep iop around 15 mm to maintain useful vision.Medically your prescription looks to be saturated,last being glycerine.A glaucoma specialist has to look at you and decide the proper method of surgery ,I feel trabeculectomy with mitomycin C will be a method to be preferred in your case.
Do keep us posted of progress.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. N K Mishra (45 minutes later)

Not sure I understand the medical terminology. What do you mean by "keep iop around 15 mm to maintain useful vision"?
Also what do you mean by "trabeculectomy with mitomycin C"?

Answered by Dr. N K Mishra (2 minutes later)

Brief Answer:
Control iop

Detailed Answer:
My dear,
the pressure you have at the moment is 28 , which should be maintained around 15 .Train with mitomycin C is the surgery you should have .

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. N K Mishra (8 hours later)

I'm sorry for not understanding but could you please clarify what you mean by "Train with mitomycin C is the surgery you should have" .

Answered by Dr. N K Mishra (14 minutes later)

Brief Answer:
Control pressure.

Detailed Answer:
My dear,
your pressure is raised and will destroy the optic nerve if left untreated.Since medication is maximum,sobthe next alternative is surgery to control pressure that is trabeculectomy with mitomycin C.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. N K Mishra (3 hours later)

I will print of this entire conversation and take it along on my doctors visit next Thursday. Will you please keep the case open till after my doctors visit? Please?

Answered by Dr. N K Mishra (28 minutes later)

Brief Answer:
ok

Detailed Answer:
My dear
You are welcome.

Above answer was peer-reviewed by : Dr. Raju A.T