Eye health (cataracts, glaucoma etc) - expert Q&A

Moses provided you were within the permitted time if you scroll back on this post you will find what you are looking for.

Hi has anyone had an answer to these questions yet? Should I be looking somewhere else for them?

Sorry, just noticed the deadline!

I was referred to the eye clinic following a visit to the optician, who said I had high pressure in both eyes and there was a risk of glaucoma. Following examination at the clinic, I was initially told that laser treatment would relieve the pressure. However, subsequent visits/examinations, seeing different consultants, it was suggested that as I had the beginning of cataracts, the surgery to remove them would also relieve the pressure and risk of glaucoma. I was asked if I would choose to have glasses for distance or reading, and I opted for reading glasses. I had the surgery to my left eye and there is no improvement. In fact my eye feels uncomfortable, as if there is a layer of water over it. At the post operative appointment I was told that as there was high pressure in my right eye, I would be prescribed drops. The drops have made the skin around my eyes inflamed and sore. My next appointment is in July.

Thanks Larry for your answer, i will certainly discuss when i am at my next eye appointment with the consultant.

Many thanks to Larry for his response. I will now do something about my vision loss, armed with this knowledge rather than think I am just being fussy and a nuisance.

Please thank Larry for his response to my question

I am not an expert but I do understand from my eye history that glaucoma has a significant family history.
I think if you have a family history and at about 40 yrs you can get your eye tests free. Or could.

There is run of 5 females in my family to my knowledge.

I have recently discovered damage to the Macula in my weakest eye (operation for lazy eye age 5 )
The photograph taken in eye hospital shocked me as it looked as if something had burst through it. They explained it as looking “ like a crumpled piece of paper “
Will it repair itself or is my sight likely to deteriorate?
I am currently waiting for a follow up appointment but it seems I might have quite a wait.
In the main time I’m worrying.

Hi Cari please thank Larry for his reply. I feel more confident about making a decision now that I have his opinion.

Hi Cari ......Please thank Larry for his helpful reply.

Cari I agree, thank you so much, that was very much appreciated.

For razzy (Do you find retired professional pilots are more likely to have faster deteriorating vision? Are there any long-term effects of the lower oxygen at altitude?)

Answer - There is a little bit of evidence for pilots getting cataracts a bit earlier and this is thought to be due to increased radiation levels (many different wavelengths) found at high altitudes but difficult to prove. Other than cataract formation I haven’t come across any other particular issue.

For Shabby (Following a cataract operation on my left eye in September 2017 I have been diagnosed with negative dysphotopsia. Although my vision in this eye is fairly good the effects of the condition are not good i.e. the shadow/dark strip on the left side of the eye and my reaction to sunlight and artificial light. Shopping can be a nightmare because of the lighting in shops. For various reasons it has taken some time to diagnose this condition because it is quite rare - my optician has never heard of it in 40 years of practicing! The discomfort I can feel varies from day to day and on a scale of 1-10 can be one or 10 with no discernible reason for the change. My consultant has offered a lens replacement using a different type of lens and has said he will place the lens slightly differently. However this is not without complications and because it is not known who or why negative dysphotopsia affects neither he or I will know if it will be successful - it could make matters worse. At my last visit to see the consultant he offered a different solution which is I have a cataract in my right eye and he thinks if my lens in my right eye was replaced it could make it the dominant eye which could lessen the problems I have in my left eye. He has no way of knowing however if I could suffer the same condition in both eyes so it would be a leap of faith on my part to have this done. I really would appreciate your thoughts on negative dyphotopsia and possible solutions to the condition.)

Answer - I see a number of such cases and they have so far all been cured by replacing the existing lens with one in what is called the cilairy sulcus. This is a space between the lens and the iris. I use a 3-piece lens (one with thinner legs) which is necessary because of its new position and to date all have been successful. It is likely that you would get the same symptoms in your second eye if you use the same implant so I usually suggest to people to have their second eye done and have a lens placed in the ciliary sulcus. I use an Alcon MA60AC 3 piece posterior chamber lens in the ciliary sulcus not in the capsular bag. Your surgeon will understand this. If this is successful then think about having the first eye lens replaced with a similar one, knowing it will work. There are potential risks with a lens exchange but they usually work well.

For annanan (My 12year old grandson has extreme sensitivity t9 light so much so that his dread on going to the dentist is more from fear of overhead light than the drill. Is that normal and does it carry some risk for future eyesight?)

Answer - Extreme light sensitivity is not usual. It is worth getting it looked at in an eye department where they can rule out known causes. It is possible that it is normal but just extreme but I would get it checked.

For candelle (I had macular hole surgery a few years ago. I was recently 70 and was required to undertake a DVLA eye exam during which I had to score 100% in the peripheral vision test*. I understand my license will need to be renewed in three years (as with everyone my age) but could you please tell me if I will have to take the DVLA test again? *I was told I had three attempts at this test and then.... no license! 
Shaking like a leaf, I first scored 119/120 but told this was a fail. I had to re-take, managing 120.)

Answer - It is unusual to have to get 100% on the Easterman field test. There are rules that need to be met but odd missed points are usually allowed. DVLA don’t allow more than two missed points together within the 20 degrees of central fixation (the spot you are looking at centrally) and there are rules about the periphery too but it would be unusual for a maculkar hole in one eye to cause a problem, as most people can drive legally with one in terms of the field of vision. As the Easterman test is carried out with both eyes open you should pass it easily assuming the other eye is normal.

For immiesnana (I had a Macular hole and lens implant operation in July 2018 and my Consultant is pleased with the result. I however feel that the vision is still slightly distorted which my Consultant says is due to scarring. I would like to know if it will improve with time.)

Answer - Distortion is usually due to a kink or scar in the retina caused by the macular hole. It can sometimes improve a little with time but is unlikely to get back fully to normal. It also should not get any worse with time.

For Christalb (I have been diagnosed with 'narrow angles' and advised that I should have a Laser Iridotomy within two years. Is this necessary, and if it is, how soon should I get it done. Should I have it done now and not wait two years??? Thank you.)

Answer - It is not possible to predict exactly when this should be done... The reason that it is time dependent is that the lens of the eye grows throughout life getting thicker and thicker. In eyes with narrow angles, the drainage channels which sit in the angles can become obstructed causing an acute form of glaucoma as the lens grows. Putting holes in the iris stops this happening (as does having a cataract out when one is older). If it needs doing there is no particular reason to wait as it reduces the risk of the acute glaucoma happening to almost zero.

For Dannirae () I have dry eyes but strangely enough they mainly only trouble me when I am even slightly stressed. For example, I can be perfectly fine, the phone will ring and if the call is anything stressful POW I have dry eyes. How can this be? I visited an optician to do with my dry eyes - she did a very thorough examination - but when I told her of my selective dry eye problem she said she had never heard of it. I am sincerely hoping that you have and can help me.)

Answer - It may be that stress makes a pre-existing mild dry eye worse for various physiological reasons. There is no syndrome as far as I know to explain this but would suggest using the artificial tears more often when it happens. Using a preservative-free drop (such as Blink or one of the hyalotears preparations) is useful as they can be put in whenever needed, with no side effects.

For ginamat (I have suffered with dry eyes and blepharitis for several years and have done all the things I am supposed to do - warm the eyelids, gently massage them and use eye drops, mainly artificial tears. I also use chloramphenicol when needed 
as I often get infections. The trouble is that my eyes are very sensitive and don't like me messing about with them too much. Is there anything else you can suggest please as it's driving me mad!)

Answer - Blepharitis is a chronic condition which needs managing – it is often controllable rather than curable. You need to be seen in an eye department if you have not already and they might suggest trying an oral antibiotic such as Doxycycline which can sometimes help with the lids if used for 3-6 months. If other methods are not working, occasional topical steroid cream can also be used but needs supervision in an eye department as it can have other effects on the eye.

For Meg54 (My eyelids on both eyes itch like fury top and bottom. I have used Blephasol, Sodium Cromoglicate, warm eye pads and baby shampoo, all to no avail. This has gone on now for over 3 years, and each morning I wake up feeling like I have been punched in the eyes! Is there anything I can do?)

Answer - Itching usually denotes allergy. If the eyelids are red/swollen as well as itchy then you may have a contact allergy (eg to the soap powder you use on your pillows/make up/make up removers/face creams – anything really!). It is worth getting this looked at by an eye doctor or dermatologist to try to work out if it is an allergy. It is always difficult to make a diagnosis without seeing the problem first hand so an appointment for this would be good. It could also be a chronic allergic conjunctivitis but again needs to be seen to be analysed.

For Hazeld (I almost always wake up in the mornings with red eyes, the actual eyeball itself is very red with red veins. What causes this and is it anything to worry about please?)

Answer - The eyes can look red in the mornings sometimes, but with no other symptoms/problems it is unlikely to be serious or significant. When lying down the veins on the white of the eye will fill more with blood than when standing up.

For Wallers5 (Why do I wake up with red eyes all the time?)

Answer - The eyes can look red in the mornings sometimes but with no other symptoms/problems it is unlikely to be serious or significant. When lying down the veins on the white of the eye will fill more with blood than when standing up.

For greciangirl (I sometimes experience bright wavy lights to the side of my eyes. Also occasional flashing lights. Is it anything serious.)

Answer - If the bright wavy lights last a few minutes and then go, they are likely to be a form of migraine. Occipital migraine (which affects the seeing part of the brain) is not usually associated with any headache (although the head can feel a bit fuzzy for a while). Classically the waves or lights grow in size or move and then disappear. This is nothing to worry about. If there is any long term affect on the vision, then it is worth seeing an eye doctor about it but if it goes back to normal each time, then not.