"Glaucoma Suspect"

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zxc - 17 Jan 2004 01:52 GMT

Went to the optometrist on Monday. He said "You have prominent optic
nerves, I'm 95% sure it is nothing to worry about, but I'm going to have you
see a Glaucoma specialist (an opthamologist). The optamologist said that my
optic nerves are "big", that he doubted that I would have any visual field
deficits when I get tested for my return visit in April, and had photos done
of my optic nerves. He said "I shouldn't worry". My pressures are 14-16
(checked twice this week). The glaucoma specialist said that I may have big
nerves from birth. I asked him if I was officially catergorized as a
"Glaucoma Suspect" and he said yes. I should add that I have 20/350 vision
both eyes, and am 30'ish years old. No family history of glaucoma.

My questions are (he wasn't able to answer them very well or I didn't
think of them until I left):

1) What % of "suspects" end up progressing to the Dx of glucoma requiring
meds or surgery? Is it inevitible that this wil happen?

2) What percent of suspects eventually go blind?

I'm a radiologist, and I've done medline searches etc with no definite
answer found to the above. Thanks to anyone with input. If you have any
radiology questions.....I'll try to answer them!

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Rick Cohn, M.D. - 17 Jan 2004 16:40 GMT

> Went to the optometrist on Monday. He said "You have prominent optic
> nerves, I'm 95% sure it is nothing to worry about, but I'm going to have you
[quoted text clipped - 14 lines]
>
> 2) What percent of suspects eventually go blind?

I can't give you exact percentages but I can tell you a very small
percentage of suspects progress to true glaucoma each year (probably
less than 1% per year). An exceptionally small number go blind. In
general, most of my patients who go blind from glaucoma do so because
of poor compliance with followup in my office (they were told to come
back in 4 months but made it 2 years instead. They return with
pressures of 40-50 and don't even know it) or they don't use their
prescribed meds and also develop significant IOP elevation. Those who
show up for their followup and use their meds generally do okay (of
course there are exceptions). I have to say, I have hundreds of
patients in my practice with large optic cups, healthy neuroretinal
rims (what's outside the cup), normal IOPs, and no family history.
These folks come every six months for IOP checks and get an HRT
(computerized optic nerve head analysis) once a year to look for
progression of optic nerve cupping. Most of these patients stay
stable over years and years, but better to be safe than sorry. Good
luck to you...don't worry...or worry just enough to keep your regular
appointments.
--Rick Cohn, MD
Glaucoma Specialist
Winter Park, FL

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