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Frequently Asked Questions about Glaucoma with Dr An Trinh
11 September, 2023
Glaucoma is a disease that requires lifelong treatment, accompanied by inconveniences affecting daily activities, bringing many worries to patients. Let’s listen to Dr. An Trinh, Head of General Ophthalmology at Prima Medical Center Saigon, answer common questions about Glaucoma to protect eyes from this “silent thief” through the article below!
Dr An Trinh, Prima Saigon, is consulting patients about Glaucoma
Glaucoma cannot be cured entirely. All treatment efforts today are only to stop the progression of the disease or slow it down and cannot restore the lost visual function in the eye.
Can the patient restore vision after treatment?
Eye damage caused by Glaucoma is permanent, which means that damage can never be reversed. Glaucoma treatment only works to preserve the remaining visual function. The parts of the visual process that have been lost have no chance of getting back. Therefore, glaucoma patients need to be treated as soon as possible.
The visual function is still early, but the patient can maintain an excellent graphic position. At the late stage, the visible part is still tiny, so no matter how well the treatment is, the results after treatment are minimal.
What should be noted when using drugs to treat Glaucoma?
The use of drugs to treat Glaucoma is the most popular method of choice today. When using the medicine, the patient should pay attention to the use schedule in terms of time and dose. This is extremely important because it is still the same drug; if we do not check at the right time as prescribed by the doctor, it can reduce the effects of the drug, even leading to overlapping side effects.
If the habit is not established, the patient will likely forget the medicine; experts encourage patients to record the schedule on paper or a reminder device. For example, until a specific time, which treatment will be used? After a while, the patient will get used to that regimen and automatically take the medicine to check.
Treatment adherence is a critical factor in ensuring the effectiveness of drug use. If it is still the same drug, but the patient needs to comply better, the treatment results are also minimal. Adherence to medication schedules plays a vital role in glaucoma treatment.
What should be paid attention to in daily life and work when suffering from Glaucoma?
Patients can live peacefully with Glaucoma and perform all tasks typically. There are no restrictions for people with Glaucoma.
However, not only Glaucoma but some other diseases, doctors recommend patients not to use alcohol. When drinking alcohol, the patient’s eye pressure will increase, which is a taboo in treating Glaucoma.
How long does it take from the onset of the disease until the disease progresses and affects vision? When is the best time to treat it?
The progression of Glaucoma depends on the type of disease. There are three main types of Glaucoma, including:
Acute form
The disease progresses rapidly in this form, leading to blindness within a few days or weeks.
Chronic form
In this form, the disease will progress very slowly. After 10 to 15 years, the disease affects a lot of visual function. However, the condition can move silently without the person knowing it. That is also the reason that Glaucoma is called the “silent light thief” because of its slow disease progression.
Intermediate form (subacute form)
In this form of disease, after a period of progression of several years, the condition can lead to the risk of blindness. The best time to treat Glaucoma is when the disease first appears. When there are severe lesions, the treatment will not achieve good results.
The way to detect the disease at an early stage is that the patient has to take the initiative to have regular eye exams, even if he is not sick. The frequency of eye exams recommended by experts is once every 1-2 years for ordinary people and 1-2 times a year for high-risk subjects (people with the same bloodline as Glaucoma patients, people over 40 years old, people with other diseases such as high blood pressure, diabetes, refractive errors, people with a history of using steroids).
What factors can increase the risk of blindness in Glaucoma?
The risk of blindness in Glaucoma is:
Eye pressure
For people with very high eye pressure, the disease will progress quickly and increase the risk of blindness. For people with moderate intraocular pressure, if there is an increase but not too high, the disease progression will still occur, but slower and longer, leading to more blindness.
Adherence
If the patient strictly adheres to the doctor’s regimen, the condition will be stable or progress very slowly. If the patient does not comply with the treatment regimen, such as using drugs at the wrong time, remembering, and forgetting, the disease will progress rapidly, leading to blindness.
Age
Usually, the disease will progress more slowly in young people than in the elderly because the visual function is less affected and damaged. The tolerance of the optic nerve cells is better.
Is there any herbal medicine or eye exercises that can cure?
Currently, no single medicine or eye exercise has been recognized as effective for Glaucoma by recognized associations or scientists.
Eye exercises can help relax the eyes and avoid myopia progression and eye strain. As for Glaucoma, no eye exercises can slow or reverse the passage of the disease.
When will the doctor prescribe the drug to treat Glaucoma? When is a laser procedure indicated, and when is surgery required?
According to the recommendations of the World Glaucoma Association, the use of drugs is the first choice in the treatment of Glaucoma. In addition, there are also several methods, such as conducting lasers and then using drugs.
If the above methods fail, then surgery is performed. The more glaucoma surgery performed in older patients, the higher the success rate.
In addition, as the patient gets older, the patient will have difficulty remembering the medication schedule. Therefore, early surgery may be considered instead of medication. For young people, the success rate will be lower, and drug use is encouraged.
Are there any risks to surgery?
Glaucoma surgery is considered relatively safe. Most patients have preserved visual function at the time of surgery. Although surgery cannot clear the eye, it cannot restore the lost part but can keep the remaining process.
After surgery, most eyes will be slightly blurred due to surgical trauma, a side effect of surgery. But in just a few weeks to 1 month, the eyes will stop confusing, and visual function will be restored.
Like any other surgery, Glaucoma surgery has a low rate of complications and risks but also needs to be considered before surgery. To limit risks and complications, the doctor will consider the most suitable surgical plan and the status of eye pressure before surgery. For example, if the eye pressure is high and the patient undergoes surgery, the risk of complications increases. If using drugs to lower intraocular pressure, with rapid effects such as oral or intravenous infusion, the risk of complications will be significantly reduced.
I was diagnosed with Glaucoma when I was only two months pregnant. Does the use of medication have any effect on the fetus? Can I have a normal birth? Will my child have it?
Glaucoma medications to date have not harmed the development of the fetus. However, in the late stages of labor, when labor is approaching, some Glaucoma drugs can affect uterine muscle tone, leading to poor uterine contractions; labour may not be possible. as expected.
In this case, depending on the actual situation, the obstetrician-gynecologist may decide to perform surgery or give birth naturally to the patient.
The Glaucoma gene is dominant on chromosome 1; some are accessory genes. When determining the gene that causes the disease, scientists confirm that this is a prevalent inherited disease. An infected person has a 50% chance of passing the infection on to their child.
I was diagnosed with Primary Open Angle Glaucoma, was prescribed eye drops, and lowered my pressure below 20mmHg. Now, sometimes, when I look at the lights, I still see halos, foggy. Will my disease develop further in the long term? Is there a way to stop the disease from progressing?
In cases of drug use, if the intraocular pressure is below 20 mmHg, this is only the intraocular pressure at the time of examination.
The peculiarity of Glaucoma is that the intraocular pressure fluctuates wildly. Especially, a lot of people have high eye pressure at night. When you visit your doctor during the day, your intraocular pressure may be relatively standard, but it may increase at night. Sometimes, the patient’s eyes will be more painful; seeing the lights have halos may be when the eye pressure increases.
To know if the disease has progressed, patients must be monitored by measuring the field of vision and taking OCT of the optic nerve every 2-3 months. If the disease has gone, the results of field measurements and OCT scans have not changed significantly; the condition can be assessed as stable.
However, it should be emphasized that stable treatment does not mean cure but only prevents the disease from progressing further thanks to treatment. Therefore, patients need to maintain treatment for the rest of their lives.
I found out I had subacute angle-closure Glaucoma 2 months ago. Although I have used the drug, I still have frequent headaches and eye sockets at night. Each time, the eyes appear halos and temporarily lose their vision, but after the pain, they return to normal. Can this disease be cured completely? Does my condition require surgery?
Fluctuating intraocular pressure is familiar with Glaucoma. This means that the intraocular pressure may be expected at one time, but high at another time. The intraocular pressure during examination will differ from that at midnight or early morning.
When the patient has a headache, pain in the eye socket, the appearance of halos, and temporary loss of vision, the intraocular pressure may be elevated.
To confirm whether this is true, the patient can be monitored 24 hours and intraocular pressure continuously throughout the day and night to determine when the intraocular pressure is frequently elevated.
When the IOP is sometimes elevated, it also shows that the treatment has not been completed, not bringing the desired target IOP. Patients can refer to changing to drugs with long-lasting effects during the day and at night or surgical treatment.
My eyes have stabilized after a period of Glaucoma treatment. Do I need to continue treatment? Do I have to be treated for Glaucoma for the rest of my life?
Glaucoma treatment must be lifelong because it is a disease that can never be cured. If, after a while, the eyes have stabilized, but the patient stops treatment, stops going to the doctor, and stops monitoring, it is a huge mistake. Glaucoma patients should pay attention to lifelong monitoring and treatment of Glaucoma to protect their vision.
After Glaucoma treatment, can my eyes be cured and pain-free? Can I stop taking the medicine after surgery?
Surgery can also lower intraocular pressure if the surgery is entirely successful. After surgery, the eye pressure will be safe; the patient will no longer need medicine. However, the complete success rate is only 60% to 70%.
In some cases, despite surgery, moderate intraocular pressure may be slightly high or still as high as before surgery, and additional medicine must be needed. Therefore, do not think that having surgery will completely heal.
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