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My Mother Has Glaucoma . She Has Very Little Vision

Posted on Wed, 1 Apr 2020

Question: My mother has glaucoma. She has very little vision (15%) and high pressure (30) in her left eye. During the past ten years she had continuous treatment (Diamox, eye drops), and four surgeries: three trabeculoctomies and one Micropulse Transscleral Photocoagulation to reduce tension in her left eye. The right eye was fine during this time, with eye pressure 15-18. Last week however she suddenly lost 50% of her vision in the right eye. She still has low pressure there (16); she had an echography of the right eye and a brain tomography (to investigate neurological cases) and nothing seems abnormal; the right eye optic nerve looks undamaged. Question: What could be the cause of her lost vision in the right eye? Could it be because of the pressure in her left eye? Is it possible that the right eye vision could improve by itself? What other treatment is available?

Answered by Dr. Harshita (12 hours later)

Brief Answer:
No deae the pressure on the left eye doesnt affect the right eye

Detailed Answer:
Hey thanks for the question . Glaucoma is usually a slowly progressive disease and doesnt cause sudden loss of vision . Therefore if she had sudden loss of vision in right eye ot is not due to glaucoma . I am unable to open the scan reports . Could you please upload the individual photographs ? Then I can help you better . Looking forward for follow up. Hope it helps . Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Harshita (43 hours later)

Dear Dr. Harshita

Thank you for the reply. I have attached more reports, as follows:
before the recent loss of vision in the right eye

scan 002, 003, 004 - Retinal Tomography Left Eye in 2019
scan 009, 010 - visual field 2018 (both eyes)

after the recent loss of vision in the right eye:

scan 005, 006 - Retinal Tomography Right Eye in 2020
scan 007, 008 - visual field 2020 (both eyes)

I hope you can see the files. If not, please let me know if it is better if I email them somewhere, and what format you prefer. They are in pdf now.

Can you think of any possibilities for what could have caused the recent loss of vision?

Answered by Dr. Harshita (4 hours later)

Brief Answer:
Yes I can think of few causes after seeing the reports

Detailed Answer:
Thank you for the reports . The left eye has a dmaaged nerve due to glaucoma . On seeing the reports of the right eye she has a dense visual field defect which can be due to a damage to the nerve . As you said the MRI Brain was normal ( as far as I remember ) then it could be due to a vascular insult to the nerve . Does she have diabetes or hypertension as they can cause them. Has she been prescribed some steroid and nerve strengthening agents? A cardiac disease can also cause vascular insult to the nerve . They are known as Ischemic Optic neuropathies . Please revert to me with the required answers . If treated swiftly We can preserve some vision in the right eye . Regards

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

Follow up: Dr. Harshita (12 hours later)

Thank you very much for the answer. My mother has indeed hypertension (no diabetes), so Ischemic Optic neuropathy is probably what is happening. She hasn't taken steroids yet, but says she will ask her doctor about Ischemic Optic neuropathy and the treatment.

Answered by Dr. Harshita (10 hours later)

Brief Answer:
Ok I am glad I could help

Detailed Answer:
Thanks for the follow up . Please let me know how it went. Regards

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