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The headache that you are having is related to raised eye pressure. 35 mmHg is very high pressure and it needs to be brought down fast otherwise there will be damage to the optic nerve. Xalatan and Betoptic drops do not seem to be sufficient. You may require more pressure reducing drops or oral drugs for a short time like Acetazolamide. If pressure is not controlled on drugs, you may have to go for glaucome surgery. Some vision will return after the pressure is brought under control but the vsion loss due to optic nerve damage is not going to come back. The steroids that were given to you could be responsible for this raised pressure. You need to discuss it with your ophthalmologist. So, you need to see a glaucoma specialist fast to save the optic nerve and vision. Best wishes to you.
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There are many drops avalable. You could have developed problems using prednisolone drops as prednisolone is a steroid and can cause increase in eye pressure. Every drop is associated with side effects in some individuals. I can understand that you can not travel and that is really unfortunate. In glaucoma treatment eye pressure has to be monitored and belive me it could be harmful for you to get an online prescription. An examination is very important. Neptazane will help to control the eye pressure but it can not be given for a long perio of time. As far as glaucoma surgery is concerned, it is done under local anesthesia and should not be such a problem. Your fitness will be assessed for this surgery before the procedure. You should discuss this with your ophthalmologist. Thanks.
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i never said i had taken prednisone drops, and you have not given me direct answers to the questions i asked, so unless you can answer exactly what i have asked, i do not acdept this answer, sorry,
thanks for sharing your knowledge and your honestly, i unfortuntaely cannot go for laser so will the eyedrops and pills be enough to control and even bring about some improvement in vision? and do you have any idea why i got elevated eye pressure in the first place at such a young age? i have clicked accept but i would appreciate it you could answer these final concerns, thanks alot,
i am sorry for bothering you again Dr. but i have some more questinos and this is too important, and you seem more knowledgable than my own doctor, was i right in reading that laser can be done in the home by the bedside? can you do this? i know this is not the ideal or conventional method or preferred but since i dont have any other option can it possibly be done? money is not a problem and i would pay you for travel expenses and whatever else you asked for, i would not be using insurance, do you have any experience at all doing this? and yoou said the pressure should come down in a day or two, i thought it took months or longer, and i have no idea what the pressure is, i just bought a portable machine and it says 24 and 20 but i am not sure if it is right and vision is no different, , please please do not say no right away, other than laser, isi there anything else tha can be done to help te BRVO and how can i be positive i have that since it was never mentioned to me? if you think you can help me knowing i cannot leave my home, please come and see me, i am in New York, where are you and could you please give me your private email? i know it sounds strange that i cannot go to hospital or have any tests done like MRI, butany travel even with ambulance has caused too severe a setback in the past and i have to preserve whateve little independence i have left, thanks so much
please please reply to my last post, and please think about coming before saying no,r cr can please let me know what you decided and if laser can be dome in the home, if it is possible,
Yes, the laser can be done at your bedside. However, this is not a procedure that I perform since I am a refractive surgery specialist. This procedure must be performed by a retina specialist. There are excellent retina specialists in NY, but I am not sure if they would make the house call that you need. Most of the retina specialists I know work in Manhattan and the Bronx. You may want to consider calling The Retina Group on Pelham parkway in the Bronx.... They may be able to assist you better than I can. Please understand that I am not refusing to help you personally. I appreciate the confidence you have in me. Its just this is not my subspecialty and I am not qualified to perform the laser procedure that I believe may help you. Best of luck....
I am so sorry to be bothering you again and again, but is there anyone you knw personally, a friend maye who is this kind of specialist who you could maybe talke to and recommend, since i find total strangers are not willing to go out of their way to help someone they know nothihg about, i would be willing to pay any extra fees for taveling to see me, and i would feel more comfortable eing taken care of by someone who was recomended and was known for doing this even in the home, i could not find any info anywhere about any laser surgery being done in the home under any unusaly circumstances, i asked for your personal email so tha we wouldnt have to go thru just answer for every conmmunication, and again, please reply as soon as you can since this is such an important matter, and again i cannot thank you enough for all your input and replies, you said you knew some specialists in Manhattan, well mabye if you told them how badly i need a house call and need to have the surgery done in my home, maybe they might be more inclined to agree, pleaes, and i would compensate you for any part you plaed in this, eagerly await your reply,
hihi Dr. i have called many doctors in N.YC. and no one is willing to travel an dno one has any idea what i am talking about when i ask if they will do the laser in the home, and they are also wondering why i am asking for a retina specalist when glaucoma is in the back of the eye, so are you sure what i need is a retina specialist? and i dont meor does an to doubt you but are you sure the laser can be done in the home? if you are sure, then i asking you, please please give mesome specific names of doctors even if they are far away from me, who have the laser in the home, because i dont think i will be able to find sonmeone who will do it and i i need somdeone to come and do it right away, not months later, my mother and sister who is a lawyer have been making all the calls and typing alot of this for me, please give me some names and numbers, and if you can find me docror who will come and do the laser, iwould pay you wahtever you think is fair, and i also wanted to know if you have any idea why the betoptic drops and neptazane has not lowerded the eye pressure at all after weeks of treatment, or does it take longer? i pray at least no further damage is being done, please please reply and i am sorry foror does it take longer pressuring and bothering you and please do not give up on me,
The laser that I am referring to is not meant to treat the glaucoma. It is meant to treat any possible swelling that may be present in the back of the eye due to the BRVO. It is important to remember that the visual loss from the glaucoma cannot be reversed but you may receive some marginal benefit if laser is performed to an area of swelling due to BRVO. I have seen retina doctors perform this procedure at the bedside using an indirect ophthalmoscope. Before you reach the point of having any laser treatment you need an evaluation to determine if such a procedure would help. I unfortunately do not know any doctors that perform house calls, but a place like Lighthouse International may be able to help. Their website is www.lighthouse.org.
In terms of the effect of Betoptic an Neptazane, they should prove effective within 1 to 2 days of use. You explain that the eye pressure is high, but I must caution you that the handheld tonometer is not as accurate as other instruments in measuring pressure and must be operated by someone skilled in its use.
Radha, please do not feel that I am holding out on giving you specific names. It is just that your circumstances are unique and require coordination with professionals willing to accomodate your needs. I don't know of any specific professionals that have done this in the past but other organizations may be able to assist. I strongly encourage you to contact the lighthouse and see where that leads.
Best of Luck!!!!
hi docgtor, you are saying the meter to measure pressuer might not be acurate, but if the pressure had come down then wouldnt i i had felt any difference in pain or vision improvement? and we did call the lighthouse international and they just help low vision lke eyeglasses and eye therapy, but not more compicated things like surgery, so i dont know how they could help me, i feel very bad constantly bothering you but since i am so secluded and canot get doctors to come and see me, i keep coming to you, and i eally need your help so tahnks for coniniuting to communicate with me, how can i be sure that i have this BRVO? just by looking and examing the eyes or can i only be positive i have it with an MRI? whihc i cannot have done , my parents think no doctor will do any laser or anything unless i can have all the ex-rays done, do you think a doctor might do the laser even without an MRI? i know i am asking too much, but i am asking again to please ask and find someone who would travel and do this laser for me, please, i dont know what else to do, please
AN MRI is not necessary to diagnose BRVO. This can be seen on a dilated eye exam that can easily be done at the bedside. Generally, increased eye pressure is not painful and therefore decreasing of the pressure would not feel different. Also, decreasing the pressure will not translate into improvement of the vision. It will only prevent further vision loss.
The only alternative to improve the vision will be an attempt at decreasing any swelling you may have in the retina associated with your BRVO. This is handled only by a retina specialist.
I'm sorry that the Lighthouse was not helpful. Have you tried to contact this retina specialist in your area?
hi doctor, i was so so surprised and i am so grateful to you for all your help, more grateful than any words can say, i called the doctor you mentioned and he will not come and see hme anyone i call all sound shocked and and reply in a belittling and condescending tone that of course no treatment where something touches or goes into the eye can be done in the home, so i am begging you to please ask someone you know who has performed the procedure you are talking about to reduce the swelling, and ask him to come and do it for me, i would pay him and you as well, you are my only hope, my vision is getting slowly worse and i am so terrified, and i am ery sorry to pressure you and bother you, but please find me someone, because i seriously doubt i will find anyone, and definately no one to do any procedure in my home, please find me someone who knows about this procedure and is willing to do it in my home, it in the home, it doesnt matter how far away the doctor is, i will pay all traveling expenses as long as he helps me, i know i am asking too much of you, but i dont have anyone else to ask, please ask your colleagues if they will come and help me, and would having the BRVO be a reason why the eye pressure might not be coming down?
The BRVO is unlikely to have any relation to eye pressure. This is strictly related to the Glaucoma. I'm sorry to hear of your continued difficulties finding help. Can you explain to me why you absolutely and under no circumstances cannot leave the house? I have never known anyone that has done laser treatment at the bedside in a patients home. However, I have seen it performed at the bedside in a hospital setting. This means that such a treatment can be done at the bedside. It would be up to the doctor to decide if he is willing to do it outside a hospital setting.
Again, I am curious to know the obstacles to you visiting a doctors office? Is all of your medical care performed at the home?
Answer these questions for me so that I have a better idea of the entire situation. If you leave the home for a regular office visit at a doctor's office are you at risk of medical complications?
hi doctor, thanks so much for replying so fast, i was waiting for you to ask me why i am so adamant about not leaving the home, yes i have alot of other problems, i have severe Postural Hypotension and lyme disease and other infectionsgo thru pure helll when i try to eat anything due to low blood pressure, low blood volume, and low blood sugar fluctuations, so wheh i have tried to travel at all, or put any strain at all on my very very weakended body, i become a total vegetable, not even abloe to sit straigt on the bedpan, or feed myself, and gothru the hours of crushing pressure and adrenaline rushes i have every time i eat, and the daily fevers and chills and headaches i get daily from lyme and other infectinos, and i suffer too severe a setback, you will justhave to trust me when i say that travel is just not possible, if i could handle it do you think i would be begging you so much to come and see me?, i dont know what else to say to convince you of how desperately i need your helpi even if this is not your speciality, ,could you consider doing this procedre or finding someone who would do it in the home, plesase i am begging you, and do you have any ideas why the eye pressure might no thave come down after weeks on medication? my vision is very blurry and dimmed,and very dark like there is no light int he room, does this sound like glaucoma or BRVO? so it is not total vision loss i think, please give me the answer i am desperately waiting to hear from you, money is not a problem to save my eyesight and at the same time not put the rest of me in jeopardy either,
i have wonderfrul parents who will vouch for everything i have said,
hi doctor, thanks again for replying quickly and for your understanding, there are still more reasons for my not being able to travel at all, but i i didnt want to go on and on and on, thanks for trusting me that it is nopossible in the condition i am in, a close friend of my dad's who is an internist is my doctor and he makes house calls and i keep in touch with yim thru email for any problems or concerns, but that is it, no other doctors of any speciality come to the home, that is why i am nagging you so much, becauv se i am in such desperate need of an eye doctor and you are realy my last hope, so what can i say or do to convince you to do this prodcedure which you sei bet you are thinking em to know alot about, or to find someone who will travel here and do it in the home? plase please do not say no, and again i am so sorry for continuiing to bother you when i am sure you already have more than enought of your own problems and too busy with your own life, but i really need your help, the sooner you can come or find someone who can come the better for my eyes, i know i am asking too too much from you but the fact]that you have continued to communicate with me and have gone way beyond the call of duty, shows the depth of character and your innate kindness, you didnt answer my question wny you thinkmaybe the eye pressure is not coming down,
i am very sorry for bohering you but since i havent heard from you i am getting nervous, please tell me that you didnt reply right away like you always do because youu are searching ans aking if anyone you know will travel here and see me, please do not give up on me,
with many many thanks
hi doctor, thanks so so much for replyng and again i apologize for bothering you so much when i am sure you are very busy, my internist knows all about my eye problems and all he has to say is that he can refer me to an eye doctor or be admitted to the hospital, but that there is nothihng he can do, so i am asking again since you do not know anyone and i have called every eye doctor within an hour of me if you would come and see me and do the procedure, please seriously considerate it, i do not mean to insult or offend you in any way, but there must be asome monetary figure that mght influence you or maybe change your mind? and i know this is not your speciality but you are still a certified and qualified eye specialist so you can do the procedure and i trust that you willhelp me, please please come and help me, what can i say to convince you? thanks and eagerly waiting your reply,
please tell me that you are seriously considering coming to see me since i cannot get anyone to make a house call and defintaely no one to do any prodedure in the home, please i beg you,
hi doctor, i am sure you are surprised to hear from me again but i am very desperate and and i am asking you again to please reconsider coming and seeing me or tryjng to find someone you know to come and see me, i have tried and tried and no one will come to my hoe and no one has any idea what i am talking about when i tell them there is a procedure that can be done in the home for the BRVO, can you tell me the exact name of the procedure you have mentioned to me in previious messages and once again i am offering to pay any amount you ask if you come and help my vision, the eyedrops and neptazane are not helping and i dont know what else to do and vision is still getting worse and i know you understood why i couldnt travel to the hospital, i would if i could, please please reply,