Question
Hello
1. If glaucoma is in one eye, some doctors prescribe glaucoma drops for this eye, while some doctors prescribe glaucoma drops for both eyes. Why for both eyes?
2. Why gonioscopy of the patient of Open Angle Glaucoma done every year? Can Open Angle Glaucoma change in to Angle Closure Glaucoma, or change in to Mixed Glaucoma (i.e. Open Angle + Angle Closure)?
3. Laser Trabeculaplasty / Surgical Trabeculectomy is for Primary Chronic Open Angle Glaucoma. Laser Iridotomy / Laser Iridoplasty / Surgical Iridectomy, is for Primary Chronic Angle Closure Glaucoma. Which surgery is for Mixed Glaucoma (i.e. Open Angle + Angle Closure Glaucoma)?
Thank you.
Respectfully yours,
Naseem ( Glaucoma Patient )
Answer
1) Sometimes glaucoma drops are prescribed prophylactically - to prevent glaucomatous damage that may occur in the future. Once a person has a diagnosis of glaucoma in one eye, there is significant chance that the other eye will develop glaucoma as well, so some doctors choose to go ahead and treat the non-affected eye for the sake of prevention.
2) While it is not terribly likely that open angle glaucoma would change into angle closure glaucoma, our understanding of the actual causes of glaucoma are still deepening through further research. There is still a lot we do not understand about glaucoma so any bit of information that can be gathered on a particular case can turn out to be helpful. It just is part of the glaucoma work-up to assess the angle because it is not just a question of open versus closed. There are gradations between the two extremes and the doctor really should be aware in each case of just how much fluid can flow out through that angle. This helps the doctor plan the treatment for a given patient. In general, older people have narrower angles than young ones, so it can be presumed that angles do get narrower over time.
3) As I am not a surgeon, detailed questions about surgery are really outside my expertise so I am going to decline to answer this one.
