Steve, just catching up on my emails from a few days ago and saw your preview of the treatments for glaucoma--I am not a paid subscriber so I'm going to post this here. About 20 years ago when I was 55, a visit to my ophthalmologist revealed that the pressure in my left eye had gone up from, I think high teens to 30 or maybe 35. The doct…
Steve, just catching up on my emails from a few days ago and saw your preview of the treatments for glaucoma--I am not a paid subscriber so I'm going to post this here. About 20 years ago when I was 55, a visit to my ophthalmologist revealed that the pressure in my left eye had gone up from, I think high teens to 30 or maybe 35. The doctor started me on latanoprost (Zalatan at the time), in both eyes as a precaution for the other eye also, and that maintained the pressure around 13 or 14. About a year later during an examination he saw that I had pseudoexfoliationfoliation glaucoma in the right eye. The latanoprost kept the pressure under control around at around 14 in the left eye and 12 or 13 in the right eye for a number of years, but then it started to go up again in the left eye. He did several SLT laser treatments that may have temporarily helped but it started going up. I couldn't tolerate the other medications. The doctor explained what pseudofoliation glaucoma was but not that it's a more aggressive form or that it weakens the structures inside the eye and more often leads to blindness than primary open angle glaucoma. My right eye is not affected at all, fortunately and that's common, that it's unilateral. I won't get into further details but I lost confidence in that doctor who I'd seen for many years, who never referred me to an actual glaucoma specialist, although there aren't many around, except for the nation leading Bascom Palmer Eye Institute, a department of the University of Miami medical school, which is in my area--there's one other glucoma specialist in the area outside of institute. although he did diligent testing with Heidelberg photography, OCT, and visual field tests, I was confidence in him when he kept suggesting cataract surgery through the glaucoma eye instead of the appropriate surgery even though I didn't need cataract surgery at that time in that eye, and change his mind about a few other things. Unfortunately started showing deterioration even though my visual field was OK, I delayed seeing another doctor because of that loss of confidence, which was my mistake. A few years ago I lost the vision completely in my left eye--I didn't want surgery because I felt by that time I lost too much vision and it may not have worked and there were other risks. I did have cataract surgery in my right eye, so I have 2020 vision in that eye and my surgeon, a different surgeon at the formation Institute, says the nerve health is like that it's like a 20 year old from the scans, So in my case it's not a genetic disposition for primary angle glaucoma, but secondary glaucoma caused by pseudoexfoliation syndrome, and only caused damage after the pressure got quite high for a long period of time, and by high I mean in the mid 30s and ultimately 50 and 60. So although the vision is lost in that eye I still have to take eyedrops to keep the pressure at what the doctor says is a stable high to prevent structural damage to the rest of the eye; in addition to latanoprost I take dorzolamide, which I know is what you take. I was also taking pilocarpine, but that's not helpful to my dystonia. Other medications, for example, brimonidine, have more systemic effects and causes problems with the eye surface and eyelids after a while.
By the way, I read that article on your old website about what you learned a number of years ago about glaucoma, before you got your substack or I knew much about you. I have been receiving Gleams for a number of years, and I'm sure the Glaucoma Research Foundation is doing good work, but I asked them a couple times why they never mention or do any research for pseudoexfoliation glaucoma, which is actually the leading cause of blindness from glaucoma worldwide. The woman I spoke to just said they are just focusing on regular glaucoma (although there are various versions of that--normal pressure glaucoma, acute angle glaucoma, etc. so why exclude pseudoexfoliation glaucoma?) The last issue of Gleams had an article by Mona Kaleem, MD, an associate professor of ophthalmology at the Wilmer Eye Institute, Johns Hopkins University, titled What Causes Secondary Glaucoma, and in that article and in her discussion on the video on the eye Institute website, she she never mentions the leading cause of secondary glaucoma, pseudoexfoliation syndrome. Because everything nowadays seems to be a conspiracy, it makes me wonder what's behind this seemingly deliberate omission, by Dr. kaleem and by Gleams in general. Not a mention of it in the number of years I've been reading the newsletter nor in the recent article devoted specifically to the subject of secondary glaucoma!
Steve, just catching up on my emails from a few days ago and saw your preview of the treatments for glaucoma--I am not a paid subscriber so I'm going to post this here. About 20 years ago when I was 55, a visit to my ophthalmologist revealed that the pressure in my left eye had gone up from, I think high teens to 30 or maybe 35. The doctor started me on latanoprost (Zalatan at the time), in both eyes as a precaution for the other eye also, and that maintained the pressure around 13 or 14. About a year later during an examination he saw that I had pseudoexfoliationfoliation glaucoma in the right eye. The latanoprost kept the pressure under control around at around 14 in the left eye and 12 or 13 in the right eye for a number of years, but then it started to go up again in the left eye. He did several SLT laser treatments that may have temporarily helped but it started going up. I couldn't tolerate the other medications. The doctor explained what pseudofoliation glaucoma was but not that it's a more aggressive form or that it weakens the structures inside the eye and more often leads to blindness than primary open angle glaucoma. My right eye is not affected at all, fortunately and that's common, that it's unilateral. I won't get into further details but I lost confidence in that doctor who I'd seen for many years, who never referred me to an actual glaucoma specialist, although there aren't many around, except for the nation leading Bascom Palmer Eye Institute, a department of the University of Miami medical school, which is in my area--there's one other glucoma specialist in the area outside of institute. although he did diligent testing with Heidelberg photography, OCT, and visual field tests, I was confidence in him when he kept suggesting cataract surgery through the glaucoma eye instead of the appropriate surgery even though I didn't need cataract surgery at that time in that eye, and change his mind about a few other things. Unfortunately started showing deterioration even though my visual field was OK, I delayed seeing another doctor because of that loss of confidence, which was my mistake. A few years ago I lost the vision completely in my left eye--I didn't want surgery because I felt by that time I lost too much vision and it may not have worked and there were other risks. I did have cataract surgery in my right eye, so I have 2020 vision in that eye and my surgeon, a different surgeon at the formation Institute, says the nerve health is like that it's like a 20 year old from the scans, So in my case it's not a genetic disposition for primary angle glaucoma, but secondary glaucoma caused by pseudoexfoliation syndrome, and only caused damage after the pressure got quite high for a long period of time, and by high I mean in the mid 30s and ultimately 50 and 60. So although the vision is lost in that eye I still have to take eyedrops to keep the pressure at what the doctor says is a stable high to prevent structural damage to the rest of the eye; in addition to latanoprost I take dorzolamide, which I know is what you take. I was also taking pilocarpine, but that's not helpful to my dystonia. Other medications, for example, brimonidine, have more systemic effects and causes problems with the eye surface and eyelids after a while.
By the way, I read that article on your old website about what you learned a number of years ago about glaucoma, before you got your substack or I knew much about you. I have been receiving Gleams for a number of years, and I'm sure the Glaucoma Research Foundation is doing good work, but I asked them a couple times why they never mention or do any research for pseudoexfoliation glaucoma, which is actually the leading cause of blindness from glaucoma worldwide. The woman I spoke to just said they are just focusing on regular glaucoma (although there are various versions of that--normal pressure glaucoma, acute angle glaucoma, etc. so why exclude pseudoexfoliation glaucoma?) The last issue of Gleams had an article by Mona Kaleem, MD, an associate professor of ophthalmology at the Wilmer Eye Institute, Johns Hopkins University, titled What Causes Secondary Glaucoma, and in that article and in her discussion on the video on the eye Institute website, she she never mentions the leading cause of secondary glaucoma, pseudoexfoliation syndrome. Because everything nowadays seems to be a conspiracy, it makes me wonder what's behind this seemingly deliberate omission, by Dr. kaleem and by Gleams in general. Not a mention of it in the number of years I've been reading the newsletter nor in the recent article devoted specifically to the subject of secondary glaucoma!