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1 29th March 10:35
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Default How long will my vision last ? (glaucoma migraine down eye)


I am 39 and was diagnosed with glaucoma in my left eye last week. My
doctor made the diagnosis after a HRT was done. My cup disk ratio is
0.64 on my left eye, 0.45 on my right eye. My doctor said there was
some obvious damage in the left eye. My eye pressure are around 19 for
both eyes. I am myopic and my disks are very large to begin with (4
mm), and I am also have migraine, and my doctor has called me a suspect
for two years.

I was put on Xalatan and my doctor said not to worry too much. He said
we will treat the other eye too.

My understanding is most glaucoma patients are elderly, and may be most
of them don't live long enough to go blind anyway. My question is does
anybody know of any statistics of young patients going blind ? I still
have 36 years ahead if I can live to the age of 75. May be I won't go
blind in the next 10 years. But what about 20 or 30 years later ?

I will appreciate if some of you can point me to any statistics/studies
or personal experience. I want to plan ahead if I know I am going to be
blind sometime down the road.

Thanks.
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2 29th March 10:35
william stacy
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Default How long will my vision last ?


Of course I will be second guessing your doc but I'm wondering a bit
about the diagnosis. Was it based on sequential HRT's or what? Did
he/she see any enlargment of the cups over time? .6 and .4 are not
particularly big cups for a myope with large discs, and 19 is not all
that high for iop. Sounds like you've got lots of nerve tissue there,
and while nobody can predict with certainty, I'd be surprised if you
were to become blind any time in your life, especially with all the
advancements in the field that have and will take place.

w.stacy, o.d.
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3 29th March 10:35
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Default How long will my vision last ? (glaucoma eye)


Thank you for your kind words William, I chope what you have said will
come true. But since I have kids to take care of I need to be realistic
and plan ahead ... (eg. start a new career which a low vision/blind
person can do, may be ?)

To answer your question, no, my diagnosis was not based on sequential
HRTs. It was based on one single HRT. My doctor said based on his
experience the shape of my left nerve cup is definitely due to
glaucoma. He has been suspicious about my cupping for two years. In the
past because I do not have a family history of glaucoma, am relatively
young, with not too high IOP, he did not think I have it, but he was
very suspicious because of what he saw using traditional equipments
(forgot the names) ... this year he decided a HRT test had to be done
and that was that.

If there is no statistics of young patients going blind I would like to
hear from clinicans like yourself, or from patients, what are the odds
for someone like me to loss useful vision and how long that will likely
take. I have heard some stories about people successful in maintaining
their eye sight for 20 or even 30 years. But I guess there must be a
lot of failure examples too.

Thanks for your input anyway.
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4 29th March 10:35
doctor_my_eye
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Default How long will my vision last ? (blindness glaucoma optic nerve)


Glaucoma is a disease that is much less likely to take your sight when
it is diagnosed early and managed well. For example, when Kirby
Puckett of the Minnesota Twins "suddenly" went blind from glaucoma, his
pressure was over 50! He now lectures young athletes all over the
world about the dangers of being a glaucoma patient for years without
being diagnosed or treated until a disaster occurs.

Your doctor is being very cautious and being protective of your sight.
Xalatan is a superior glaucoma drop in that it has been shown to not
only lower the pressure on the optic nerve, but is has also shown an
ability to protect the optic nerve from damage in the future by
shielding the nerve from future damage. This drug and others in its
class are all less than 10 years old, so "old" studies of blindness
from glaucoma are not as relevant because the nature of the disease and
our ability to treat it has changed so much for the better.
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5 29th March 10:35
william stacy
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Default How long will my vision last ?


Most glaucomas are slow to take vision, usually affecting peripheral
vision long before central vision goes, usually taking years to even be
noticed by the patient.


Maybe I'm not as sure about HRT as he is. But again I'm second
guessing. Anyway, I'm suspicious enough to recommend a 2nd opinion by a
glaucoma specialist. After all, we are talking about a life sentence of
eyedrops/what-have-you treatment and expensive monitoring. If your doc
is a glaucoma specialist, then fine, ask him how soon your type will/can
cause you occupational problems.

I have heard some stories about people successful in maintaining

Sure, most people do not outlive their glaucoma. BTW did you do visual
fields? Any demonstrable field defect? If so, I'll yield to that, but
if not, get that 2nd opinion and be sure to report back here.

w.stacy, o.d.
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6 29th March 10:36
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Default How long will my vision last ? (glaucoma optic nerve eye)


I am happy to know that Xalatan does more than lowering IOP, since I
read that for normal tension glaucoma there are some other mysterious
factors that contribute to optic nerve cells dying off, rather than
just high eye pressure.

If you are a clinician would you mind telling me if NTG are more
difficult to treat and has a higher rate of vision loss, even with
treatment, when compare with POAG ?

Thanks again for your time.
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7 29th March 10:36
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Default How long will my vision last ? (glaucoma optic nerve)


Thanks again for responding.


Just to have an idea if someone with an earlier stage of glaucoma
receive no treatment at all, how long does it take for her to loss
peripherial vision, and how long to loss central vision ? Is there any
general trend in this ? I know every case is different, but is there
any concensus on the natural history of this illness ?


I don't know who is considered a glaucoma specialist, but I think more
than half of his patients see him for glaucoma. I was told I have
normal tension open angle glaucoma. Thanks for the suggestion I will
ask how it will affect my occupation.

No, none of my visual field test shows anything unusual, so my
diagnosis was based on the condition of my optic nerve. I was told that
it takes quite some damage to have an effect on visual field. Is that
correct ?

Thanks for your time.
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8 29th March 10:36
william stacy
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Posts: 1
Default How long will my vision last ? (glaucoma optic nerve ophthalmologist eye)


The disease has many different variables, knowns, unknowns, courses, and
treatments. And different experts will give you different opinions. Add
to that the theories are changing as more is learned. There are some
things that are pretty well "concensus" but not all. It really does vary
from eye to eye. I know it sounds screwy, but there is a lot we don't
know about this disease.

Glaucoma specialists limit their practices to glaucoma cases. Sounds
like he might be a general ophthalmologist with a "special interest" in glaucoma.


Modern field testers are pretty good at picking up early damage, but
yes, once it shows up on field testing, significant damage has been
done. But since you have no field loss, I would still question the
diagnosis, not because I don't believe your doctor, but because there is
no precise recipe for that diagnosis that everyone agrees on. I
personally believe that in some cases like yours, unless a change in the
optic nerve can be do***ented by photography or other optic nerve
imaging, the diagnosis may be premature. Ergo, the 2nd opinion, and if
they disagree, get a 3rd and go with the concensus. You've got lots of
time.

w.stacy, o.d.
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9 29th March 10:36
doctor_my_eye
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Default How long will my vision last ? (glaucoma)


By definition, normal tension glaucoma is harder to diagnose and is
often left untreated for extended periods of time because it is often
undiagnosed for years. So, your question is unfair in a certain way.
For example, the recent statistics from the National Transportation
Safety Board concluded that minivans had less crashes per thousand
vehicles than any other kind of vehicle, and there were fewer
fatalities per thousand vehicles. Can you conclude from those
statistics that minivans are the safest vehicle to drive? No, you can
only conclude that the KIND OF PERSON that drives a minivan is the
least likely kind of person to crash and die. So, since you are an
early diagnosed LTG patient who is being watched closely with
nerve-protecting prophylactic care, you are more likely to save your
sight than the "average" LTG patient.
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10 29th March 16:21
gudrun17
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Posts: 1
Default How long will my vision last ? (glaucoma optic nerve eye)


Is it always true that there is significant damage once a visual field
test shows a defect? In my case, if there weren't a repeatable visual
field defect (it is mild but widespread) I think I would still be
considered a glaucoma suspect because with normal eye pressures and a
deceptively healthy looking optic nerve, there wouldn't be much else to
go on, other than a borderline sector in HRT. Despite the visual field
defect I was told my case is early or mild. I wish it could have been
caught before there was any vision loss but as I said, with normal
pressures and myopic disks I understand it can be hard to diagnose.
-Gudrun
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