Hi. I'm online and happy to answer your question today.
are you available to chat?
Hi. Cosopt and Azarga are very similar medicines. They both have the drug Timolol, a beta blocker, in combination with a carbonic anhydrase inhibitor. Cosopt has Dorzolamide and Azarga has brinzolamide. I would consider them almost the same in their ability to lower intraocular pressure.
yes, I am now available to chat.
In deciding when to start a patient on glaucoma medicine I look at many things: The eye pressure, the health and morphology of the optic nerve (called the "cup to disk ratio"), the health of the nerve fiber layer, the morphology of the outflow channels (called the angles, this is checked with gonioscopy), visual field changes, as well as the patients history, age and rate of change of the above parameters,
Perhaps that is why your ophthalmologist wanted you to start drops in the right eye?
The main point in my question was if it is recommendable to use a pressure lowering medicine in an eye with good pressure. Especially, if once the use of such medicine is started, the patient will probably will have to keep on using it for the rest of his life.
That is correct about maybe having to use if for the rest of your life. As I pointed out before there are times when the pressure may be in the "normal" range and the optic nerve is still showing damage consistent with glaucoma. Perhaps this is what your ophthalmologist is noticing in your case ( I hope you are not trusting your glaucoma treatment to an optometrist!)
As to why he would switch you from Cosopt to Azarga? I'm not sure. They would be expected to give the same level of eye pressure control. If more were needed I would add a drop such as Travatan to the cosopt.
Is it true that once you start using pressure lowering medicine in the eye, you will probably have to keep on using it for therest of your life and that therefore you do not styart administering such a medicine till it is absolutely necessary.
No. That is not exactly true. Drops can be started and stopped if they are found to not be working, surgery or laser can be used that make taking drops no longer necessary etc.
One thing that is true, however, is that nerve tissue -- and the vision that goes along with it -- can never be restored or regained once it is gone. In that light, I would not be too quick to delay starting therapy to avoid a "lifetime of drop usage"
In our system the optometrist is not supposed to give medication, so it is always the ophtamologist who is the one responsible for medicines..
I wish it was like that in the States. I can' tell you the times I've had a patient finally come to me for treatment after an optometrist has been "treating" them for years while they slowly went irreversibly blind.
Have we covered all the issues you wanted to review?
What is the main factors on which a decision to operate a cataract is besed?
orrection: What is the main factors on which a decision to operate a cataract is based?
This is my last question.
What is the interpretation of 20/50?
At that level the risks of the surgery are much less then the expected benefit so it is worth it. This is also the level that the government and insurance companies use to pay for it so the patients don't have to
Thank you dr. Rick.
I'm not good at metric: 6/6 is the same as 20/20, Let me see if I can look it up quickly
But if you are having a lot of glare issues from the cataract you could safely have it removed sooner....
Got it. 20/50 is 6/15
It has been my pleasure to help.
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