I went for my follow up appt and it was recommended that I have the laser surgery as soon as possible. I was rather confused because my IOP was 12 and 15 and my optic nerve was considered healthy. The day after my appt I went for a second opinion with an ophthalmologist who was familiar with Dr. Ritch in New York (I believe this is right). This physician stated I was not a candidate for laser sugery because of the shape of my lens. He confirmed that yes I have PDS, a mild case (what does mild mean)light dusting noted, and questable K. spindles. I decided to use the latter MD, based on his credentialing.
I am suppose to go back in November to have my IOP tested without dialilation then I quess he'll give me recommendation for treatment. He did concur that I should avoid strenuous activities and caffine.
My question, should I have some type of treatment to prevent PG? My first ophthalmologist felt strongly that I needed to some type of defense against PG developing. I would appreciate any feedback. Also, what do ya'll think, do I need a third opinion?
Wow, aren't we getting into some tricky areas. Firstly I must say that there is genuine debate in this area, so no definite answer. Plus I can't make any personal judgment without looking at your eyes myself.
So what can I say on the subject. If it's laser iridotomy we're talking about, and I think it is, there are some theoretical guidelines.
Laser iridotomy can prevent pigment liberation from the iris. So patients should be in the pigment liberation phase (this is related to iris shape and position). This is best identified by dilating (making larger by pharmaceutical means) the pupil and looking for pigment liberation.
Pigment liberation is a PDS effect found in younger persons too so normally an age limit is applied (under 45 or under 50 are common ones).
Also the laser procedure liberates a fair amount of pigment in itself so it is normally used only on people who already have raised IOP.
These are general guidelines but this is an area where there isn't a lot of good quality evidence. Thus some or all of these could be wrong.
How does this apply to you: You're at the top end of sutiable age wise and your IOP is normal which might lead us away from insisting on laser. But I can't be sure.
And I certainly can't tell you whether two or three opinions is enough or which one to go with.
Sorry I can't be more help and If I haven't made myself clear please post again.
Just had a routine check-up at the glaucoma clinic, have been going every 6 months for just over 20 years. Hopefully I can reassure you about your situation in comparison with mine. My IOP was 14 in both eyes generally has run around 12 and 13 over the years kept htere by daily eye drops. My Dr. told me this pressure was still below average. My original Dr. who dealt with me over the past 20 years is a national authority on glaucoma - Dr. Raymond LeBlanc. At no time has laser surgery ever been mentioned and since I was in my late 20s when it was discovered that I had increased pressure and a small amount of vision loss in my left eye, I feel strongly that if that had been a better option than the eye drops that I have used over the years it would certainly have been proposed and discussed. You can check out Dr. LeBlanc`s credentials by googling his name. Of course every case is completely individual so I can only relate my own expereinces.
I appreciate both replies. I guess I'm going to wait and see what Dr. Depperman suggests in November. I would think that eye drops would be suggested at that time. I guess my biggest fear is nothing will be suggested and one day I'll wake up with a real big problem.
I went yesterday to have my pressued checked again and to have a picture taken of my optic nerve. Prior to going to my appt. which was at 2:45 I decided to jog 6 miles. I jogged at 11:30, had my pressured checked at 4:30; 16 and 17 was the IOP. My pressure has increase but it may be related to the jog. Noted spindle in rt eye. The optic nerve looked healthly.
My question: The physician has decided that my case is mild, the nurse even stated, "maybe the next time you come, you won't even have this", has decided that monitoring is the best treatment for now. My next appt is in 6 mths. I'm concerned because when I was first diagnosised I was told I needed to do the lazer or start the drops immediately. What do ya'll think?
I just wanted to comment here...This sounds just like my situation before I was diagnosed. In nine months I saw my eye pressure go from 10 and 11 up to 34. As it was on the rise I kept saying it was beyond my comfort zone.....What about what is high for the individual?