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Diagnosed with glaucoma, have low resting pulse rate. How would that worsen the glaucoma?

I am am in my early 60 s and diagnosed with glaucoma . I also have a low resting pulse - in the 50 s - although I am not diagnosed with bradycardia . I do not experience faintness, dizziness, exhaustion, shortness of breath. I am a regular exerciser - moderate to brisk walking 4 - 6 days/week. My opthomologist mentioned to me that low pulse rate could actually worsen the glaucoma, particularly when I am asleep. I didn t understand his explanation of why - something about the blood flow being insufficient to infuse the optic nerve properly??? I need a pacemaker to treat my glaucoma???
Asked On : Tue, 30 Oct 2012
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Ophthalmologist 's  Response
The eyeball, in order to be a solid structure that maintains its form by making fluid, aqueous from the epithelium that covers the ciliary processes. This fluid which is like water, mostly water, flows into the center of the eye, in front of the lens, through the pupil, into the anterior chamber and out of the drain, the trabecular meshwork, to the aqueous veins and into the blood stream.


And the eye stays a certain firmness. Not too hard, not too soft. The eye makes like...for instance, 5 drops per day and drains 5 drops per day. As long as it does this, the pressure of the eye remains 'normal'. And in 'normal' pressures, everything works. But as the wall of the eye, the sclera is sort of tight, blood vessels have to have enough pressure to get blood INTO the eye through the wall into that pressurized ball. As long as the pressure, the blood pressure, is MORE than the eye pressure, blood enters the eye and goes through the vessels and the leaves the eye...everybody happy. Yea.

But, what if the eye that is producing 5 drops a day stops draining down to 4 drops a day? Then the pressure of the eye goes up, cuz the guys making the fluid don't know about this slow down on the drain, and it goes up and up until the eye drains 5 drops a that new pressure. As long as the pressure isn't "too high", the blood enters the eye and everything is ok. But if there is a relative strangulation of the vessels that supply the nerve head, then the nervous tissue gets ill or sick. There isn't enough blood supply to the nerve fibers and some of them begin to die. usually it's the ones next to the wall of the hole....sort of like 5 people trying to get out the door at the same time and pushing...the ones against the door edge get squished. Since the nerve fibers that are against the edge of the nerve get injured first, and those nerves come from the front part of the retina, we lose our side vision first. It's a very slow process. Usually the pressure is "relatively" high, so there's a slow process that kills the nerves.

Another way of looking at it would be that the pressure of the eye is just fine, thank you very much. But the perfusion of the nerve head by the blood pressure is "low". The result is the same, a relative lack of blood supply to the nerve and it gets sick even though the eye pressure is sort of normal or low! Same result.

It takes YEARS to go blind from glaucoma. I'd recommend you not test this theory. So all you need do is lower the eye pressure below "normal". Take lumigan or Asopt, or Timolol, or Betalol, or whatever o l o l.... all different types of "glaucoma" drops which lower the pressure and some actually are neuroprotective as well. Have your doctor Rx you Lumigan or something! That way even with a relatively low blood pressure the theoretical threshold of nerve damage is diminished as much as possible.

I have "low" blood pressure. I can Rx my own drops. But as my nerve heads are "normal", I don't even think about it. But if you have signs of nerve damage, by all means slow the process down if you can....take the meds. Leave your low blood pressure ALONE!
Answered: Thu, 8 Nov 2012
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