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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10788
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My glaucoma was diagnosed 6 years ago at age 48 when I lost

Resolved Question:

My glaucoma was diagnosed 6 years ago at age 48 when I lost central vision. This vision loss occurred without previous loss of peripheral vision. I have a dark arc in my central vision left eye. My pressures had gone from 21 to 35 within a 3 year period. Have you seen this type of vision loss in your experience? All information I've read describes peripheral loss first. Do you have any explantions for this central loss? My pressures remained in low teens for 5 years following diagnosis with drops then began shooting up again causing some peripheral loss but lowered with further medication. What sort of prognosis would you give me with this extent of optic nerve damage. Also, are the MS and Parkinson treatments for optic nerve protection available now. Is there a reasonable chance of maintaining remaining vision over 30 yrs? I still have 20/20. Would you think it is realistic to still be driving in 5-10 yrs.? Thank you for your support. Debbie Gove
Submitted: 5 years ago via Glaucoma Research Foundation.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

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

Dr. Rick :

are you available to chat?

Dr. Rick :

wow! Lots of questions there.....

JACUSTOMER-gnn0gz0l- :

Yes

Dr. Rick :

hi. Lets go through them in order, shall we?

Dr. Rick :

Yes, I've seen that happen in glaucoma.

JACUSTOMER-gnn0gz0l- :

Is there a known cause for central loss first?

Dr. Rick :

There are many reasons for this central vision loss. It could be due to a nerve fiber layer infarct in the maculopapular bundle, damage to the macula, the visual area in the cortex....the list is very long and diverse -- depends upon the physical findings

JACUSTOMER-gnn0gz0l- :

Does this indicate more adanced severe glaucoma or more severe prognosis?

Dr. Rick :

It is impossible to give you a prognosis on further vision loss, how long you will maintain 20/20 vison, or how well you will be able to drive in a decade from now (heck, I don't even know how you drive now :o) Even with all your data in front of me, even if I had been your treating doctor for years it would be impossible to give a meaningful answer to this question.

Dr. Rick :

central vision loss in glaucoma does indicate more advanced disease in the majority of patients

Dr. Rick :

MS and Parkinson medicine have no place in the discussion concerning glaucoma treatment.....

Dr. Rick :

Are you being treated by a glaucoma specialist?

Dr. Rick :

I think we got all the questions covered.....

JACUSTOMER-gnn0gz0l- :

Are the Parkinsons and MS medications presently used to protect optic ner damage? I read about these treatments on the Gleams website. Yes I'm being treated by an opthomologist.

Dr. Rick :

no. They are not prescribed solely to protect the optic nerve in glaucoma. It would not be the standard of care to use these meds in this way.

Dr. Rick :

Is she a glaucoma specialist?

JACUSTOMER-gnn0gz0l- :

No he is not - a general opthomologist.

Dr. Rick :

Ok. If you are worried you could consider obtaining a second opinion by a fellowship trained glaucoma expert. It does, however, sound like you are very informed about your disease and are getting good treatment with your current doctor.

JACUSTOMER-gnn0gz0l- :

O.K. Thanks for your time. I often don't get the chance to ask many questions during my visit and the central vision question has been plaguing me for years. I wondered why I went straight to central loss with no peripheral. My new doctor told me yesterday I have extensive optic nerve damage which puts me at high risk for future vision loss, so I'm processing this and along with the anxiety about the future. Thanks again

Dr. Rick :

my pleasure. have a good evening and thanks for letting me help you tonight.

Dr. Rick :

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Expert:  Dr. Rick replied 5 years ago.
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