03 Relapse after 18 months

DECEMBER 17, 2008

 

Here is the page that I had hoped I would not be writing. With all the history so far with this condition, and the situation is now worse than before. Recently, I have had some “events” or situations where I knew that the pressure in my eye was again going way up. With the expectation of the trabeculectomy being a long lasting fix for the problem, this was most disappointing.

 

Even more disturbing, I now find that I have the problem in both eyes. From all the research, it was indicated to me that the problem would, as some stage, start to present also in my left eye, but that seemed to be happening very slowly, and I was beginning to think that such a problem was a lot further into the future. However, it is evident that it has to be dealt with now. As mentioned in the previous pages on this issue, my problem is not actual glaucoma, but very high inter ocular pressure induced by exfoliation material being present within the aqueous humor of my eyes. When this material builds up and is released and starts to “float” around in the fluid in the eye, it blocks up the drainage through the trabecular meshwork resulting in a dramatic rise in pressure. This exfoliation syndrome evident within the body in many places without any particular problem except in the eye. Why a systemic problem would surface for me in only one eye is still totally unknown. However, it is there by degrees now in both my eyes but the problem is not the same in each case. So, it is like having two problems, same nature, but different stages of development.

 

I visited the eye hospital again yesterday knowing full well that the problem was occurring again, particularly in my right eye, and not sure of just why that could be happening. The only reason would be that the surgical procedure to open a vent in the top of my eye to relieve the pressure had now stopped working. Why it was coming right up in my left eye was another big concern because it could only really mean that the problem was also progressing rapidly there also.

 

Upon having the ophthalmologist check the pressures, it was found that both eyes are showing a pressure of 38, way too high and causing damage without any doubt. This had to be controlled immediately to avert serious damage continuing. The action indicated was to take some of the diuretic called Diamox again as well as starting immediately on the glaucoma drops in both eyes to reduce the pressure. I have done all this, and I know that the pressure is down a lot lower. Just how much lower remains to be seen, and I will be returning to the hospital tomorrow to find out the result. Depending on how well the pressure is now contained will determine what further actions are needed and within what time frame.

 

The examination also revealed that the trabeculectomy that was performed in June last year has healed over and is no longer able to relieve any pressure as it was designed to do. The only alternative seems to be to have another similar procedure performed in my right eye, and it may also be indicated for my left eye as some stage down the track. For the moment, it is wait and see, but it is a certainty that the struggle against this problem will go on for many years to come. I guess that I have to be thankful that at least there is help available, and that blindness can and will be averted for me in this day and age. More reports to be added to this page soon.

 

DECEMBER 19, 2008

Today I had the follow up to the the visit of two days ago where the bad news of the deterioration of my condition was confirmed. I have, of course, followed the directions of the doctor carefully and carefully observed the full medication schedule.

 

Today the news is a little better, and slightly more encouraging. The pressures are reduced to almost normal levels which is a great releif as it does show a good response to the medication. My left eye is down to 14 and that is about as good as it gets. The right eye though is at 21 and while this is good, it is a little higher than we would wish for to ensure no further damage done to the optice nerve.

 

I asked a lot of questions, and came up with some new information about the condition. Last time, the pressure was 38 in both of my eyes, but I could see the halos only from my right eye giving me the impression that the pressure in that eye must have been higher. However, the explanation is simpler but not really good. Because of the damage to my optic nerve in my right eye only due to the condition over the long time to date, my pupil will dilate more to accommodate the lower sensitivity. The doctor says that he can clearly see this, and I have occasionally had people comment on this difference in the size of my pupils but I shrugged it off as just a natural and normal phenomena. Quite fascinating how the eye is able to make these automatic adjustments and accommodating the changing conditions and actually do that independently of eachother. Again, I am impressed by the workings of our eyes and feel like I would like to really scream the message to everyone about the need to protect their eyes at all costs. I guess, just as I have been for years, we do take such things for granted and only really appreciate them when there is a threat such as I have here.

 

For now, it is again wait-and-see (no pun intended) on what will happen. I visit the hospital again on January 09, 2009 and will update the story at that time unless there are other unusual events in the mean time.

 

JANUARY 16, 2009

 

I did not attend the hospital on the 9th as planned as I was busy with other things, and feeling very confident that there was no problems going on. I felt that an additional week before I had the check up would be no problem, and allow the Xalatan to fully kick in and show what is really going to happen longer term.

 

Today I did go and saw Dr Yupin once again. She is very helpful as always, and my pressure readings were as I had thought, but I was still releived to have the confirmation and the readings put into my record of treatment. My left eye is responding very well, and the pressure there seems stable at 17 – a very normal pressure. For the right eye, the one that has had the problem for all this time is also responding well now, and the pressure is reading 21. According to the doctor, this is still a little too high for this eye given the history and the damage already sustained. The target is to have the right medication to maintain a pressure below 20 and preferrably at around 16 for long term assurance that no further damage is done to the optic nerve.

 

The action for the moment is to continue medication in both eyes with the Xalatan once every day in the evenings. It is not such an imposition, and certainly good to see that things are under control again. If the right eye does not respond further, and a pressure well below 20 is achieved within the next three weeks, we will have to change the medication to another one that is newer, and research shows that it is a little more effective. Hopefully, my next report will be equally as optimistic and for the moment, the threatened repeat of the surgical procedure is not on the cards for the immediate future.

 

FEBRUARY 06, 2009

 

Great news! Today I went along for the check up and the whole problem seems to be under control. Pressure in the right eye is only 15 and in the left is down now to 13. These figures are great and a real relief to know that the medication is working very well.

Prognosis now is pretty good for the year at least. I am not going back to the hospital again for a check for another two months. Of course, I had to buy enough of the Xalatan to last over that time and that was a bit of a hit for the finances. Otherwise, all good news and more to this article in a couple of months. Hopefully the situation will still be the same at that time.