Questions & Answers

The Diaton tonometer is an instrument developed to measure eye pressure through the eyelid. This device has been compared to the gold-standard Goldmann applanation tonometer, and has been shown to mildly under-estimate the intraocular pressure. It is approved for use in Canada, and has potential for glaucoma patients due to its ease of use. No topical anesthetic eye drops are required, making this device a potential means of measuring intraocular pressure outside of the clinical setting.

Headaches and dizziness are not usually symptoms of late-stage glaucoma. Some eye drops (timolol and brimonidine) can cause some dizziness in certain patients due to their effect on the cardiovascular system. None of the eye drops should cause headaches; however, very high eye pressures can cause headaches and eye pain. You should speak to your eye care provider and primary care doctor about your symptoms to determine their cause.

There are many "good" candidates for glaucoma surgery. Patients who cannot tolerate topical medications due to side effects, costs, or non-compliance are good candidates for surgery. Patients whose eye pressures are not adequately controlled with medications and/or laser trabeculoplasty are also good candidates for surgery. Finally, patients with narrow-angle glaucoma, traumatic glaucoma, and uveitic glaucoma can benefit from for surgical intervention. The goal of glaucoma surgery is to stabilize the intraocular pressure at a low level to prevent progression of the disease.

Patients with myopia are 2-3 times more likely to develop glaucoma. However, this onset of glaucomatous vision loss is usually asymptomatic. Myopic patients also have increased risk for retinal detachment, and some are also at risk for choroidal neovascularization, a process similar to "wet" macular degeneration. The irritation and blurred vision you are describing may be unrelated to glaucoma or retinal pathology; it may be related to ocular surface issues and dry eye. Your eye care provider can help to determine your risk for glaucoma and the cause of your irritation and worsening vision.

The Occu-Plus formula is marketed as a nutritional supplement for overall eye health. It contains 17 vitamins, minerals and herbs. None of the ingrediants have been shown to lower eye pressure. If you are having intolerable side effects to the eye drops, you should discuss other options for lowering the eye pressure (alternative eyedrops, laser trabeculoplasty, glaucoma filtering surgery) with your eye care provider. There are no known eye exercises to help reduce the eye pressure. Please note that vitamin, mineral and herbal supplements should be taken under the supervision of a doctor.

Glaucoma is a condition where, if untreated, damage occurs to the optic nerve and vision is affected. The natural course of the disease is progressive visual field loss and potential total loss of vision. However, treatment of glaucoma by lowering the intraocular pressure has been shown to halt disease progression. If a patient is already on treatment to lower the eye pressure and an increase in optic nerve damage is noted, further treatment to lower the eye pressure to a lower level is indicated. Options to lower the eye pressure include eye drops, laser surgery, and glaucoma filtering surgery. There are some studies concerning the use of gingko biloba, bilberry extract, and pine bark extract and their potential for protecting the optic nerve and lowering eye pressure; however, the effectiveness of these supplements is still under investigation. In general, there is very little data on using supplements in the treatment of glaucoma. Following a balanced diet, taking a multivitamin, and regular aerobic exercise contribute to overall eye health and are recommended for patients with glaucoma, and it is always prudent to employ these strategies under the supervision of a doctor.

The visual symptoms and findings you describe could be casued by a few different processes. A mild attack of angle-closure glaucoma would result in blurred vision, halos, redness, eye pain, headache, and a mid-dilated and poorly reactive pupil. This attack can resolve spontaneously. Additionally, some medications (cold/allergy medications, motion sickness medications) can cause mild dilation of the pupil and blurred vision that resolves spontaneously. Only an eye doctor can rule out potential intermittent angle-closure glaucoma in your left eye as well as other conditions that may have contributed to your symptoms.

The “waterfall or rippling effect” in the peripheral part of your vision fits the description of a scintillating scotoma. These visual phenomena are often seen with ophthalmic migraines. Small flashes of light in the peripheral vision as known as photopsias, and are often a sign of retinal disease. These phenomena are not commonly seen in glaucoma. However, some patients with normal-tension glaucoma often have a history of migraine headaches, and thus may experience these phenomena. Only your eye doctor can provide you with detailed information concerning the cause of your specific symptoms.