Hi Axel,
Unfortunately, hard to say if your doc is a "good one" or not...to
me the tools are not as important as the communication and your level
of comfort. It does sound, based on your description, that you
probably do have glaucoma, but without seeing your optic nerve I can't
know for sure. I'm sorry I don't know anyone in Dayton, but if you are
concerned, a second opinion certainly couldn't hurt.
I seldom start Travatan as a first line agent because of the
redness. I almost always start with its cousin, Xalatan, first as it
is much better tolerated. Well fewer than 1/2 of a percent of my
patients require surgery because they can't tolerate ANY of the drops
out there. Even if they are allergic to the preservatives in them,
there are preservative-free versions of several available. Good luck
to you,
Rick Cohn, MD

axel grease

Thanks Dr Cohn,
Here is more info to go on...
My opthalmologist is a DO, not an MD. He was chosen because my insurance
plan at work pays for glasses through his office and other vision care
companies are too far away and/or have no evening or Saturday office hours.
The medical part of this is being paid for by my major med insurance plan
(separate from glasses plan).

Initially, a *Optomap* device made a scan which seemed to show some
"cupping" of the rim of the optic nerve around the blood vessels at the back
of the eye. The doc admitted that may be a birth defect since he had no
previous scans to compare to. However, a visual field map showed loss of
vision in some regions.

After 2 doses of the Travatan the redness of the sclera was very severe, but
the IOP went down. Also, Travatan seems to have had a carry-over effect
even 5 days out. My IOP was back down to 18 or a bit less. My
opthalmologist wants to get the numbers down more. He gave me a sample af
ALPHAGAN-P (Brimonidine Tartrate Ophthalmic Solution, 0.15%; Alpha-agonist )
to use once per day for a week and then 2x daily for 3 weeks if I can
tolerate it.

After one dose, I am not seeing redness with the ALPHAGAN-P drops, but it
does "itch" for a while after I put them in, just prior to going to sleep.

Axel

sherry

Normally, regular medical insurance will pay for eye conditions other
than routine eye exams and glasses for refractive problems. Check with
your insurance - bet they'll cover a ophthalmologist or glaucoma
specialist for glaucoma. Because of the glaucoma diagnosis when I get
a refraction, my medical insurance will cover that - however, not
glasses.

No way would I see an optometrist to treat glaucoma! Sorry if I offend
any optometrists monitoring the list with my comment, but that's just
the way it is - glaucoma is a *medical* condition that needs a
*medical* doctor and preferably a specialist, at least for proper
diagnosis and to get treatment started. I'm being followed by my
ophthalmologist but he refers me back to the glauc doc when necessary.

I really don't think optometrists keep on top of medical conditions of
eyes - some even still think glaucoma is diagnosed by elevated IOP -
wrong!

If I had no major problems with my eyes and only needed glasses, I'd go
to an optometrist - went to one for years - and my glauc doc has an
optometrist in his office for refractions after surgery.

Sherry

axel grease

Sherry,
If elevated IOP is not the criteria, then what tests should I be looking
for?
I need to know because there seems to be a shortage of glaucoma specialist
MDs around here. I want the right tests and the right Doc.

I also tested as having some loss of visual field. I noticed what seems to
be progressive night blindness starting about a year or more ago,b ut
thought it was just "age". My eyes hurt frequently, but I also have
allergies and horrid sinus trouble. I've only had one sinus headache in my
lfe. It started in 1953 and it is still going.
Axel


<snip>

sherry

Glaucoma is diagnosed based on damage to the optic nerve. Visual
fields, HRT, gDX and a good dilated visual exam of the optic nerve by a
glaucoma specialist are good ways of determining the presence of
glaucoma.

Some people have ocular hypertension - elevated IOP - and never develop
glaucoma. Others have normal pressures and have glaucoma.

According to http://www.retina-international.org/nightbld.htm, loss of
peripheral vision can result in night blindness, however night
blindness has to do with the rods and not everyone who has night
blindness has glaucoma.

Sherry

axel grease

Sherry,
I do thank you for that clarification. Now, perhaps I can procede on a more
reliabel track.

Axel