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Dr. JP
Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
Satisfied Customers: 28
Experience:  Harvard Medical School, Massachussetts Eye and Ear
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I am an intelligent and pretty young woman of 44. and Scarred

Customer Question

I am an intelligent and pretty young woman of 44. and Scarred to Death! I am on a television talk show daily. Since I can remember I can not see well at all from my Right eye.It is like seeing through a film of plastic wrap.. When I was little they said I had stavrism. I went to get a Full eye exam and for glaucoma for the first time in 25 years. Everything was excellent Dr. said I should Keep Same -1.25 w/astigmatism., Prescript I have for 25 years I was happy. In 7 months I went Another Dr. because my eyes were dry. my old Dr. retired. New Dr.raises my prescript to -2.75 & says I have lateral degeneration. Prescript too strong did not use. Went to another he said I have a cataract of a 80 year old. Went to Another because my bad eye started seeing lights and lots of worms doctor said just getting older. The last doctor yesterday suggested surgery to my GOOD EYE (oh my gosh) to open a whole in my iris because he believes I have a Narrow Angel but NO high pressure? What do I do?
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. JP replied 4 years ago.

Wow...you've got a lot of things here. Let see if I can narrow this down to a list.

 

1. refraction problem (myopic astigmatism)

 

This can be sorted out with glass prescription. The change in refraction from -1.25 to -2.75 can be from cataract.

 

2. macular degenration (age related change to the central vision portion of the retina)

 

In the early portion of this condition you should consider taking AREDS vitamins (this has beta carotene or lutein, vit C, vit E, zinc). You should have annual dilated eye exams. Discourage smoking. Vision would have distortion to central vision and not things floating around. This distorition would be when the macular degenration changes from dry form to wet and typically is found in older individuals. Unlikely in your situation but remember I haven't had the luxury of examining you.

 

3. Floaters in your vision

 

This is most commonly from vitreous synerisis or a vitreous detachment both of which are typically observed and not treated as they rarely have serious vision threatening comlication in the long run.

 

4. Narrow angle

 

this is when the iris insertion is in close proximety to the corneal angle making it harder for the fluid in the eye to exit. It can cause elevated eye pressure, eye pain and can damage the optic nerve if the angle was to close. Prevention of the closure is done with a simple iridotomy that is performed with a laser. Individuals do very well with procedure.

 

It seems that you have cataract changes, mild macular degeneration, narrow angles and refractive changes. The cataract changes for a 44 year old would make me want to know why the cataract is there? Steroid use, trauma, previous infections, uveitis. If you do have a cataract is plausible that the cataract is enlarging thus pushing on the iris and thus causing the narrow angle. If this were the case, I'd perform a laser iridotomy to prevent closure and then do cataract surgery.

 

Without having seen you myself, it makes it hard for me to definitively tell you whats going on.

Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
Satisfied Customers: 28
Experience: Harvard Medical School, Massachussetts Eye and Ear
Dr. JP and other Eye Specialists are ready to help you
Customer: replied 4 years ago.
I just wanted to clarify that I can not see with my right eye.This is the one with the major cataract of an 80 year old and the one I saw flashes, worms, & cobwebs floating around as I move it. My doctor said it was not due to a detachment and therefore prescribed Prednisolone 1% eye drops for that eye for three weeks. Thank God, none of these conditions can be seen by the general public, nor by me in the mirror.

Also, my "Good Eye" the left one, is the one that the Doctor has said has gotten much stronger and that is why he has left me with the same prescription of -1.25 for so long, and that is really great. He therefore advised me that the -2.75 that was previously prescribed by someone else was incorrect for my "Good Eye" (Left eye).

Now, my deepest concern is for my "Good Eye." The eye pressure in both eyes were taken yesterday and my doctor said both are excellent. So, why should I bother my good eye with an iridotomy, what if something goes wrong? I read of many scary side effects.

The strange thing is, I have never been told i had a narrow angle in my eyes until two days ago. Does this condition just appear? I was at the doctor's a month before when i complained about the worms (floaters) of my bad eye and at that time I was not told about my good eye having a narrow angle then. He just told me to come back in a month to reevaluate the cataract and floaters and that is when he redid the tests and told me I have narrow angle in both eyes and am also developing a cataract in the good eye.

Also, you mentioned trauma, I have never had any trauma to the good eye. However, I have been reading quite a lot and am almost 24/7 on the computer doing work till 3:00 a.m. for for the past year and a half and have lots of work related stress. So, could stress and overworking my eyes have any effect on my eye health?

It it possible that i have an ear, nose, throat infection which is pressing to upper cheeks and temples and eyes? Sinuses?

Lastly, I'm not sure if this makes any difference to the health of my good eye, but in the inner part of the sclera there is a pinguila and the doctors say it is from too much sun exposure.

I'm extremely worried about my good eye and would appreciate any input. I am scared to have an iridotomy and something go wrong. After all, I only have one good eye.
Expert:  Dr. JP replied 4 years ago.

narrow angle doesn't just appear spontaneously. it comes on insidiously and requires a goinioscopy to diagnose. thus the clinicXXXXX XXXXXkely did this due to suspicion on examination. it's fairly easy to treat and is important to treat to prevent the angle from closing completely which could lead to severe eye pain, corneal swelling and decreased vision. if treated the likelyhood of complete angle closure is unlikely.

 

as for the pinguecula, just observation is needed, to prevent progression just wear sunglasses when in sunny conditions. you can use natural tear drops to help if there is discomfort. typcally these are benign and not a problem for patients.

 

as for the sinuses. it is possible but would typically have pain over the sinus and feel sick, have difficulty breathing and have prior history of sinus disease.

 

JP

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