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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2690
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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June of 2009 I had glaucoma surgery on my good left eye..right eye

Customer Question

In June of 2009 I had glaucoma surgery on my "good" left eye because of high pressure of over 23. After surgery, which is my second surgery, I had the same problem with my right eye, and many visits to the doctor my pressure became very, very low a 2. My sight has been compromised and with time has not returned or improved. My last visit measurement was 0. Do you have any suggestions besides returning back to the surgery table that can help me. I do have Uveitis and have had many years of problems and lots of prednisone treatments, which has probably caused my glaucoma. The doctor did snip a stitch in the bleb with no success. I'm at a loss and don't know what else to do and I'm concerned about the low pressure and if it will do any further damage. Thank you. XXXXX XXXXX
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. Stan replied 4 years ago.
Hello,

Welcome to JA.

Few questions to assist me in helping you:

How long ago was the most recent surgery in the right eye?

What are the vision in each eye?

When was your last visit to the eye doctor?

I await your reply. Thanks.
Customer: replied 4 years ago.
The right eye had surgery about 4 or 5 years ago. It's the left eye that has the current problem.

The vision is not good, maybe 20/200 in the left eye and 20/100 in the right eye. I do drive though with very strong lenses in my glasses. Hope this helps you

My last visit was Thursday Dec.3rd. At Shiley Eye Center in San Diego. I've been to UCLA and USC uveitis doctors.
Expert:  Dr. Stan replied 4 years ago.
Hello,

Thank you for your reply.

It appears that you have excess filtration from the bleb and/or that the exacerbation of the uveitis caused significant inflammation of the cilliary process where the fluid of front of the eye is made. With such increased inflammatiion of the cillary process, there is reduced ability to make aqueous fluid, causing decreased pressure. For the pressure to be zero, it is most likely that you have both of these two processes at play (contributing) in the decreased of your eye pressure.

In the immediate period, the management approach will be to reduce the inflammation with topical steroid, which could also help increase the pressure by itself (a desirable effect in this time). In general, such effect will take several days to few weeks to cause a noticable increase pressure. You do not want such low pressure for too long, as you want to avoid damage of the macula (hypotony maculopathy) due to prolonged low eye pressure. In that case, the best immediate solution to increase the eye pressure would be surgical of revision the glaucoma filtraion procedure. This procedure is straight forward and will take much less time. It involves tightening of the sutures to decrease filtration from the bleb. I encourage you to do what they advice you. God bless.

It was a pleasure to assist you.

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Please note that this answer is for information only. It cannot be substituted for the visit to or the recommendation of your doctor.


Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2690
Experience: Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
Dr. Stan and other Eye Specialists are ready to help you
Customer: replied 4 years ago.
Thank you so much. Your answer was very helpful. It is hard to get answers when you have to go to a teaching medical school because of interns and students requiring the doctors attention. Thank you again! One more question: should I have the surgery done asap? Alyse
Expert:  Dr. Stan replied 4 years ago.
Hello,

Thanks you for you reply.

Yes, I would encourge you to have the surgery done as soon as you can to avoid hypotony maculopathy as I explained before. I trust that you will do well. God bless.

Please, do not press the accept button a second time, as you already did before.

A Positive Feedback and/or Bonus is welcomed and appreciated.

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