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What Do Debilitating Eye Pressure With Headaches Indicate Despite Negative CT Tests?
Question: Hello,
My father is 90 years old, with a history of Heart Failure and DM's. He has been experiencing increase eye pressure to his eyeballs and a headache over his forehead. It is almost debilitating at times. He said it gives him a "sicky" feeling and all he can do is lay down. He has had CT of his head, sinuses and neck. The head CT and sinus was negative. He has been placed on allergy medication, prednisone and antibiotics without relief. His neck CT showed degenerative changes. He was give a steroid injection into his posterior neck 3 to 4 weeks ago, this seemed to ease his head pain. But the eye "pressure/pain" continues. Cataracts, glaucoma and a list of common causes of eye pressure/pain have been ruled out. The only thing he has mentioned that seems to give him relief is when he lifts his eyelids up off of the eyeball. I am desperate to see if anyone can help my father. He didn't retire from working until he was 80 years old and healthy and well enough take care of his home and help neighbors with theirs until his mid eighties. Since then he has had a pacemaker placed, been diagnosed with diabetes and CHF. But none of those Dx's have affected him and impacted his XXXXXXX like this eyeball pressure. He now spends most of his days in bed or going to specialists, Ophthalmogists, Optometrists, ENT, Neurologist, Family Practice provider, even a specialized chiropractor seeking help for this unknown eye problem. PLEASE HELP. I do not want my fathers last months, years to be spent this way. I know if someone, somewhere could help us he again could lead a more active, productive and quality life.
A very concerned daughter,
Gilda XXXXXXX
My father is 90 years old, with a history of Heart Failure and DM's. He has been experiencing increase eye pressure to his eyeballs and a headache over his forehead. It is almost debilitating at times. He said it gives him a "sicky" feeling and all he can do is lay down. He has had CT of his head, sinuses and neck. The head CT and sinus was negative. He has been placed on allergy medication, prednisone and antibiotics without relief. His neck CT showed degenerative changes. He was give a steroid injection into his posterior neck 3 to 4 weeks ago, this seemed to ease his head pain. But the eye "pressure/pain" continues. Cataracts, glaucoma and a list of common causes of eye pressure/pain have been ruled out. The only thing he has mentioned that seems to give him relief is when he lifts his eyelids up off of the eyeball. I am desperate to see if anyone can help my father. He didn't retire from working until he was 80 years old and healthy and well enough take care of his home and help neighbors with theirs until his mid eighties. Since then he has had a pacemaker placed, been diagnosed with diabetes and CHF. But none of those Dx's have affected him and impacted his XXXXXXX like this eyeball pressure. He now spends most of his days in bed or going to specialists, Ophthalmogists, Optometrists, ENT, Neurologist, Family Practice provider, even a specialized chiropractor seeking help for this unknown eye problem. PLEASE HELP. I do not want my fathers last months, years to be spent this way. I know if someone, somewhere could help us he again could lead a more active, productive and quality life.
A very concerned daughter,
Gilda XXXXXXX
Brief Answer:
monitouring of iot and type of glaucoma tobe diagnosed. steroid be avoided
Detailed Answer:
Your daddy is in advanced age with cardiac problem and all necessary treatment have been given like pacemaker fitted treatment is alright but IOT is to be constantly taken for monitoring of glaucoma.Type of glaucoma should be diagnosed like it is open angle or close angle. Field tracing should be done it has got treatment like drop ,tynalol tablet like diamox and surgery like trabeculectomy. In your fathers case only thing is steroid should have been avoided which will induce diabetes,enhance IOTand masking of symptoms by which monitoring is difficult since you have started now.Tapering is to be done. Field of vision specialy tunnel vision is to be excluded and peripheral field is to be traced. Fundus examination and cup disc ratio is to be noted.Dark room test ,water drinking test should be done.With advance age care is to be taken to avoid acute congestive glaucoma.Treatment of glaucoma is not proper.Consult eye doctor for review and a second opinion may be taken for sinus x-ray, PNS is to be taken and if sinus is involved then antrum wash out can be done.take second opinion on management of glaucoma.Consult neurosurgeon for advice on degenerative condition of spine with proper treatment his quality of life will improve.Need to consult ophthalmologist, neurosurgeon and others as on when required like ENT surgeon for sinositis.Better to find out family physician who will take care without much problem.
monitouring of iot and type of glaucoma tobe diagnosed. steroid be avoided
Detailed Answer:
Your daddy is in advanced age with cardiac problem and all necessary treatment have been given like pacemaker fitted treatment is alright but IOT is to be constantly taken for monitoring of glaucoma.Type of glaucoma should be diagnosed like it is open angle or close angle. Field tracing should be done it has got treatment like drop ,tynalol tablet like diamox and surgery like trabeculectomy. In your fathers case only thing is steroid should have been avoided which will induce diabetes,enhance IOTand masking of symptoms by which monitoring is difficult since you have started now.Tapering is to be done. Field of vision specialy tunnel vision is to be excluded and peripheral field is to be traced. Fundus examination and cup disc ratio is to be noted.Dark room test ,water drinking test should be done.With advance age care is to be taken to avoid acute congestive glaucoma.Treatment of glaucoma is not proper.Consult eye doctor for review and a second opinion may be taken for sinus x-ray, PNS is to be taken and if sinus is involved then antrum wash out can be done.take second opinion on management of glaucoma.Consult neurosurgeon for advice on degenerative condition of spine with proper treatment his quality of life will improve.Need to consult ophthalmologist, neurosurgeon and others as on when required like ENT surgeon for sinositis.Better to find out family physician who will take care without much problem.
Above answer was peer-reviewed by :
Dr. Kampana
Dr. XXXXXXX Dash -
I believe my father was recently (within 2-3) checked for Glaucoma and told his pressure was normal. When you say constant monitoring for glaucoma, how often should he be monitored?
You can having a pressure type discomfort to the posterior and anterior eyeball with glaucoma?
What does field tracing show?
Is Tynalol used for pressure?
Can field tracing determine if he needs an Trabeculectomy?
The steroids were tried approx 1 to 1 1/2 months ago, he only took for less that 5 days because there was no improvement noted.
If I am understanding you correctly a field of vision to r/o tunnel vision needs to be completed and a peripheral field trace?
Fundus examination and cup disc ratio noted. Correct?
A dark room test and a water drinking test should be done.
He has had a CT of his head and sinuses, both were negative.
Should he still have sinus xrays done?
Do you think he has glaucoma that has not been properly diagnosed?
Can you have glaucoma without an elevated IOP?
Next step should be a second opinion with an Ophthalomologist, continue F/U with Neurosurgeon and keep family practice provided involved.
Thank you,
Gilda XXXXXXX
I believe my father was recently (within 2-3) checked for Glaucoma and told his pressure was normal. When you say constant monitoring for glaucoma, how often should he be monitored?
You can having a pressure type discomfort to the posterior and anterior eyeball with glaucoma?
What does field tracing show?
Is Tynalol used for pressure?
Can field tracing determine if he needs an Trabeculectomy?
The steroids were tried approx 1 to 1 1/2 months ago, he only took for less that 5 days because there was no improvement noted.
If I am understanding you correctly a field of vision to r/o tunnel vision needs to be completed and a peripheral field trace?
Fundus examination and cup disc ratio noted. Correct?
A dark room test and a water drinking test should be done.
He has had a CT of his head and sinuses, both were negative.
Should he still have sinus xrays done?
Do you think he has glaucoma that has not been properly diagnosed?
Can you have glaucoma without an elevated IOP?
Next step should be a second opinion with an Ophthalomologist, continue F/U with Neurosurgeon and keep family practice provided involved.
Thank you,
Gilda XXXXXXX
Brief Answer:
yes proper diagnosis and treatment for glaucoma is recomanded.
Detailed Answer:
yes investigation an treatment for glaucoma is not complete. second opinion regarding recomandation of proper treatment and other helpful investigation yes without raised iot there can be glaucoma. itis called normotensive glaucoma. iot will be normal but effect of change will be manifested family physician should be involved that is to give you relief to avoid run round to different practitioner with this age it is disturbing.before decision his approval is essential dark room and water drinking test are provocative and confirm diagnosis. xray pns is more confirmative to diagnose sinositis ct scan will not be that helpful.for degenarative spine. with proper treatment wait for sign of improvement.
yes proper diagnosis and treatment for glaucoma is recomanded.
Detailed Answer:
yes investigation an treatment for glaucoma is not complete. second opinion regarding recomandation of proper treatment and other helpful investigation yes without raised iot there can be glaucoma. itis called normotensive glaucoma. iot will be normal but effect of change will be manifested family physician should be involved that is to give you relief to avoid run round to different practitioner with this age it is disturbing.before decision his approval is essential dark room and water drinking test are provocative and confirm diagnosis. xray pns is more confirmative to diagnose sinositis ct scan will not be that helpful.for degenarative spine. with proper treatment wait for sign of improvement.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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