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Medical Forum / Diseases and Disorders / Glaucoma / September 2004Causes of glaucoma?
Greetings, all: I'm new to glaucoma, diagnosed in July. I was wondering if anyone could tell me what the causes of glaucoma are? My opthalmologist said it's not related to my diabetes (type 2, diagnosed in March and well controlled) or my extreme myopia (-12 correction in each eye). Nobody else in the family has glaucoma or optical problems of any kind. Other than my myopia, the only other problem I've had with vision was a retinal hemorrhage about 10 years ago, the cause of which was never determined. The opthalmologist says my optic nerve is quite large and "flat"... 0.99 is the number he used I believe, although I don't really know what that refers to. My pressures before medication ranged from 17 to 21 in the left and 21 to 22 in the right (which is also the one with the greater visual field deficit). So far Xalatan alone was insufficient to bring the pressures down to where the doctor wanted them, and now I am trying Azopt. So anyway... what on earth causes this?? anka hi ankalime.....i had an email to write you about glaucoma...i wonder if you could email me with a good addy as i have many questions for you since i am in the process of findin out for sure is i do have or not......thankyou so much little joe littlejoewashere@webtv.net (Little Joe) wrote in news:3528-413A772D-472 @storefull-3173.bay.webtv.net: <snip> i am in the process of findin out for > sure is i do have or not......thankyou so much > > little joe Joe, What kind of questions do you have? How are you trying to find out if you have glaucoma? Are you seeing a glaucoma specialist? What kind of tests have been done? Dr. Rick Cohn is our resident glaucoma specialist from Orlando, FL. I'm sure he's currently waiting out Hurricane Frances! Hope you're safe, Rick! Sherry I wonder if the meds for copd -occasional steroids can cause glaucoma . ? I had cataracts that my Opthamalogist said was caused from steriods -for my copd -emphasema -when they were removed ( cataracts ) My pressure went down and I am off all glaucoma meds --go figure !! Steroids can induce glaucoma. The Cataracts were most likely interfering with the fluid drainage of your eyes, which caused an increase in eye pressure (glaucoma). Once removed, the drainage becomes improved, pressure goes down. Dr. Ted Roxan http://visionupdate.net/ >I wonder if the meds for copd -occasional steroids can cause glaucoma . >? I had cataracts that my Opthamalogist said was caused from steriods >-for my copd -emphasema -when they were removed ( cataracts ) My >pressure went down and I am off all glaucoma meds --go figure !! Dr. Roxan responded to Trish with: >Steroids can induce glaucoma. The Cataracts were most likely >interfering with the fluid drainage of your eyes, which caused an [quoted text clipped - 10 lines] >>-for my copd -emphasema -when they were removed ( cataracts ) My >>pressure went down and I am off all glaucoma meds --go figure !!<< The latest edition of Eye To Eye from The Glaucoma Foundation, with which Dr. Robert Ritch is associated, comments, "It has been known for some time that steroids in any form can cause a rise in eye pressure...all individuals, regardless of glaucoma history, should have an eye examination if steroids (even inhalers or skin preparations) are to be used on a long term basis..." I was recently prescribed (again) a steroid inhaler and ran the monograph from an internet site. It included, "Glaucoma and osteoporosis are possible adverse effects associated with a long-term use of large doses of corticosteroids." Nevertheless, doctors in general (including ophthalmologists) seem to continue to prescribe steroids for glaucoma patients, so it's up to the patient to say "no." It should also be kept in mind that most Vitamin D supplements are steroids, as is cholesterol. I've had to be on Pred Forte (a steroid eye drop) following every one of the surgeries I've had in my glaucoma eye the last several years. That includes the trab I had done at the end of July. I'm now tapering off the Pred Forte. My pressure did go from 15 to 23, and my doctor said himself the Pred Forte was probably interfering with drainage. But on the other hand, with a trab it's important to prevent scar tissue from closing up the hole, and the steroid is supposed to help with that. Hopefully, once I get off the stuff, my pressure will come down somewhat. In any case, it seems even ophthalmologists who know the risks nevertheless feel that sometimes steroids are necessary in the short run. Laura >Nevertheless, doctors in general (including ophthalmologists) seem to continue >to prescribe steroids for glaucoma patients, so it's up to the patient to say >"no." It should also be kept in mind that most Vitamin D supplements are >steroids, as is cholesterol. > It should also be kept in mind that most Vitamin D supplements are >steroids, as is cholesterol. Does this mean that the Vitamin D supplement I take along with calcium to prevent osteoporosis is going to heighten my IOP? Cheers, Ann To email: replace 'REMOVE' with 'b' in email address. Cholesterol is a steroid? Does this mean high serum cholesterol could be a cause of glaucoma? > The latest edition of Eye To Eye from The Glaucoma Foundation, with which Dr. > Robert Ritch is associated, comments, "It has been known for some time that [quoted text clipped - 10 lines] > "no." It should also be kept in mind that most Vitamin D supplements are > steroids, as is cholesterol. The steroid that can cause Glaucoma is Prednisone. Dr. Ted Roxan http://visionupdate.net/ >Cholesterol is a steroid? Does this mean high serum cholesterol could be a >cause of glaucoma? [quoted text clipped - 25 lines] >http://www.newsfeeds.com - The #1 Newsgroup Service in the World! >-----== Over 100,000 Newsgroups - 19 Different Servers! =----- > The steroid that can cause Glaucoma is Prednisone. > > Dr. Ted Roxan > http://visionupdate.net/ Do you mean Prednisone can cause Glaucoma or that Prednisone can raise IOP while you are taking it? Do you mean that other steroids don't have this effect? Are there any non steroid anti imflammatories that you recommend? Thanks for answering my question -- I have one more ; ) I think the med I take for copd Advair has a steriod -One of the drugs in this med is salmeterol, a steriod? will this one cause me probs with my eyes ? the other drug is fluticasone. I am also on atrovent in the form of a new drug called Spiriva --as I understand it --the only way it causes glaucoma is if you get it IN the eyes --right ? Advair does have a steroid. The amount is on the label -- one of the ### / ### numbers. I can't remember which one, but I think it's the higher one. When I was on it, they said it stayed in my lungs and wouldn't cause problems with my glaucoma. Nevertheless, I was glad to get off of it. Laura >Thanks for answering my question -- I have one more ; ) > [quoted text clipped - 3 lines] >the form of a new drug called Spiriva --as I understand it --the only >way it causes glaucoma is if you get it IN the eyes --right ? > Advair does have a steroid. The amount is on the label -- one of the > ### / ### numbers. I can't remember which one, but I think it's the [quoted text clipped - 12 lines] > >the form of a new drug called Spiriva --as I understand it --the only > >way it causes glaucoma is if you get it IN the eyes --right ? A study by Samiy, et al, in the Canadian Journal of Ophthalmology in 1996 looked at the IOP of 187 patients before and after starting inhaled corticosteroid treatment. They found no significant IOP elevation in these patients after three months of followup. Another larger study found only a very mild risk of IOP elevation with prolonged use of high dose inhaled steroids. Therefore, I wouldn't worry too much about it, especially if you are getting your IOP checked fairly regularly anyway. Hope that helps. Rick Cohn, MD Glaucoma Specialist Winter Park, FL Interesting! Thanks, Dr. Cohn. >A study by Samiy, et al, in the Canadian Journal of Ophthalmology in >1996 looked at the IOP of 187 patients before and after starting [quoted text clipped - 7 lines] >Glaucoma Specialist >Winter Park, FL > Greetings, all: > [quoted text clipped - 18 lines] > > anka Good question, Anka. There are known risk factors for glaucoma, but no definite cause. I'm the only one in the family with glaucoma also. Both of my parents and both sets of great grandparents had very good vision. My great- grandfather had diabetes and I don't know of anyone else in the family with it. And high myopia, hypertension and hypothroid don't run in my family either. Guess someone has to be first, eh? Dubious honor! Diabetes *is* a risk factor, as is high myopia, migraines, hypertension, hypotension - basically anything that interferes with good blood flow,and some other eye conditions. The big questions for me are - why do some people have high intraocular pressure (IOP) and never develop glaucoma? Why do some people have "normal" IOP and develop glaucoma? Why are babies born with glaucoma? What is it about trauma to the eye that causes glaucoma? Why do meds work on some people and not others? Why do some people have laser surgery, trabs, use drops and *still* can't get their pressures down to a reasonable range? Is there a genetic mutation going on here in some cases? Sigh. If we had the answers to these mysteries, maybe we could find a way to prevent glaucoma and/or a "cure"! Hopefully the memantine study will prove the drug to be of positive value in protecting the optic nerve! http://www.glaucoma.org/news/gleams_jul00.html Sherry <not a doc, just a fellow glaucoma patient> The word I see coming up to describe what glaucoma * IS * is neuropathy, e.e. damage to the optic nerve. If I understand Dr. Cohn and other sources correctly, IOP in and of itself isn't the factor. It's what's happening to the optic nerve. And since blood flow affects the health of the optic nerve, that'd be a reason why conditions that affect circulation would be risk factors in glaucoma. That's why I take neuroprotective antioxidant supplements and try to eat lots of the foods that have been shown to help protect the eyes. This kind of research generally tends to be more for the retina, but seems to me that anything that's good for the retina is also good for the optic nerve. Lots of dark green leafies, bananas, orange juice, lutein, zeaxanthin, etc. And, of course, a generally heart-healthy diet so those arteries don't get clogged. Laura >Good question, Anka. There are known risk factors for glaucoma, but no >definite cause. [quoted text clipped - 25 lines] >Sherry ><not a doc, just a fellow glaucoma patient> |
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