I'm posting this for a friend.  He's a very talented artist, and has
been told that he may well soon go blind from advanced glaucoma.  He's
now 55 years old.  He was first diagnosed with glaucoma in his mid-20's
but did nothing about it until his mid-40's, when he first began to
notice vision loss.  He's seen an ophthalmologist since 1999, who, upon
her initial examination, proclaimed that he had severe optic nerve
damage, and advanced glaucoma.  The pressure at that time, in each eye,
was over 30.  Through the continued use of alphagan p, cosopt and
xalatan, the pressure has dropped substantially and now ordinarily
hovers between 10 and 15.

His doctor mentioned the possibility of surgery (a trabeculectomy), but
this was prior to the stabilization of the pressure, with which she
seemed relatively pleased.  She suggested that although surgery could
bring the pressure down even further and could last several years
before another surgery would be necessary, it would definitely cause
even further vision loss.  He recently saw another MD, who looked over
his records, did a pressure check, surveyed the optic nerves, and told
him that his glaucoma was now in the end stage.  On the other hand, he
can still see well enough (at least in one eye) to paint.

He's only seen two doctors for his condition, and I don't believe
either were at world class medical centers.  (He's in the LA basin
area.)  Any recommendations as to possible new treatments, clinical
trials, evaluations he should have, etc.?  Any suggestions would be
greatly appreciated!

P.S.  In addition to waiting far too long to seek treatment (partly
driven by financial considerations and no health insurance), he also
engages in a number of likely lifestyle no-nos for glaucoma patients.
He smokes a pack of cigarettes a day, and drinks 2-3 cups of coffee a
day.  Also, about three times a month, he parties, and drinks a six
pack of beer at a setting.