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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I am 53 years old and had laser eye surgery for myopia 8 years

Resolved Question:

I am 53 years old and had laser eye surgery for myopia 8 years ago. I now wear contact lenses +2.25 in one eye and +1.25 in the other to help with reading.
Yesterday I had an eye examination which revealed some thinning at the optic nerve (?). It was a scan looking for glaucoma. I am now going to have a visual field test.
Do you think that contact lenses should not be worn? I take medication NSIS 40mg for high blood pressure, which is controlled, too.
Thanks
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Are you available to chat?

Dr. Rick :

Was it an ophthalmologist or an optometrist who told you that your optic nerve was a little thin?

Dr. Rick :

however, to answer your question: Contact lenses will have no adverse affect on your intraocular pressure or your optic nerve. Should you be diagnosed with glaucoma and started on drops to lower your pressure you may want to wait to put in your contacts for five minutes after using the medicine.

Dr. Rick :

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Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
k
Expert:  Dr. Rick replied 3 years ago.
Just as an aside...if it is an optometrist who is diagnosing, and thinking of treating your possible glaucoma, I would run -- don't walk -- out of the office and get to an ophthalmologist to learn what is really going on with your optic nerve. Optometrists, in my opinion, have no place in the treatment of a potentially blinding disease.
Customer: replied 3 years ago.
Thanks for your helpful reply. I am english but live in France hence the desire for an english language second opinion. It was an ophthalmologist who did the testing so that's ok, but can I just check the results with you?
I received a print out from the test.. are you familiar with this..it was titled "stratus OCT RNFL thickness average analysis report". There were a number of pie charts and a table which showed OS and OD results the OS had a number of red areas (are these indicating the problem?) I cannot seem to make sense of them. The figures for overall thickness were OD = 96.32 and OS = 83.62 and OD-OS = 12.70.
Of course I can ask the ophthalmologist at my next appointment but it would be great if you could help me make sense of them too.
Regards
Expert:  Dr. Rick replied 3 years ago.
Yes, I am very familiar with that data and would be happy to review if for you. Can you scan them into your computer? If so, you can upload them to me like this:


Save your picture on your computer, someplace easy to find it such as your desktop.
Upload your picture to the site tinypic.com by browsing for it as directed.
Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.
Copy the link inside this box and then paste it into your justanswer dialog box and send it to your expert.
Customer: replied 3 years ago.
I seem to be having problems uploading this on to the tinypic site. It is responding as failed due to invalid format. I have tried again as a pdf but this didnt work either..any ideas?
Sorry for the bother
Customer: replied 3 years ago.
http://i51.tinypic.com/51rg9d.png
Expert:  Dr. Rick replied 3 years ago.
I got it....let me take a look. By the way, I thought MY signature was hard to read :o)
Expert:  Dr. Rick replied 3 years ago.
I've reviewed the data....had to print it out as it was kinda small on the computer screen :)

There is only a slight "dip" in the thickness of your nerve fiber layer (NFL) in your left eye. Think of the NFL as the "cable" that takes the picture and sends it to your brain for processing.....damaged cable=damaged vision.

The picture of your optic nerve shows a normal cup to disk ratio with symmetrical disks. OCT results are sensitive to a number of variables and I would not be concerned about this one small statistical "red area" on one OCT scan.

When diagnosing glaucoma I look at a number of things: Optic nerve morphology, intraocular pressure, angle anatomy (where the fluid drains from the; this is evaluated with gonioscopy), visual field testing, OCT data and clinical/family history.

I think your chances of having glaucoma based on these test results, all other things being unremarkable, is very low.


It is now safe to press that pretty green button ;o)

Let me know how else I can help. If you would like this answer in French, I can have my Aunt Melanie, who has been teaching 7,8&9th Grade Munchkins French for over 20 years, translate it for you (This is where you smile and,if needed, laugh a little)

Take care.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 3 years ago.
Thank you so much. And yes I did laugh a little, not a bad thing at this time of night, stressed and exhausted. So time for bed now not worrying, for the moment anyway, about going blind!

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