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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2405
Experience:  MS Ophthalmology with 13 years of surgical expereince
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Well my eye preasure is getting higher than it should be(or

This answer was rated:

Well my eye preasure is getting higher than it should be(or that's what my doc says) he recommeded I have a glacoma surgery. Putting a tube in my eye to relieve the preasure.
Is this really necessary or is there something else I could do to relieve the preaure. Well this tube be in my eye long, and well it create problems

Dr. A.S. Desai :

Hello, Welcome to Pearl.com


 

Dr. A.S. Desai :

Are you available for chat now?


 

Dr. A.S. Desai :

Glaucoma is usually tha last resort after the other modalities of glaucoma treatment such as eye drops or lasers have failed to keep the intraocular pressure(IOP) under control.


 

Dr. A.S. Desai :

Trabeculectomy ( or trab) is the usual recommended surgery for chronic glaucoma which is not responding to medical line (eye drops) or laser treatment ( argon laser trabeculoplasty-ALT or SLT).


 

Dr. A.S. Desai :

I can see that you have entered the chat.


 

Dr. A.S. Desai :

Please go through the replies and let me know if there is anything else you would like to know.


 

Customer:

never had a laser treatment


 

Dr. A.S. Desai :

If you have not been seen by a glaucoma specialist then it makes sense to do so as they are the better judges for deciding the correct line of treatment in a particular type of glaucoma.


 

Dr. A.S. Desai :

The first thing to know would be - which kind of glaucoma you have been diagnosed with( primary or secondary open angle glaucoma).


 

Dr. A.S. Desai :

If primary open angle glaucoma(POAG) then how long was the medical line of treatment tried, how much is the extent of vision and visual field loss on perimetry.


 

Customer:

Don't know if there is one near me, my surgery is wed

Dr. A.S. Desai :

Why have you been put on a steroid eye drop(pred forte eye drops)?


 

Customer:

Had a partial cornea transplant

Dr. A.S. Desai :

Moreover putting a tube in the eye for glaucoma is actually a less often performed glaucoma surgery called as artificial drainage device-ADD or SETON.


 

Dr. A.S. Desai :

There are different types of tubes available and are restricted to resistent glaucoma where trab has failed too.


 

Customer:

So whats this laser treatment

Dr. A.S. Desai :

Laser treatment or ALT is an office procedure in which green laser is aimed at the part of the eye where the block for aqueous drainage is suspected ( at the trabecular meshwork).


 

Dr. A.S. Desai :

It is a safe procedure and can be repeated too.


 

Dr. A.S. Desai :

There is a possibility that the steroid eye drops could have caused the glacuoma-steroid induced glaucoma. However the treatment options would be the same as POAG.


 

Customer:

So would you recommend having a laser before the tubes

Dr. A.S. Desai :

I haven't examined your eye so I could be wrong in giving suggestions. But what I have mentioned is the routine protocol followed for glaucoma- first is the trial of medical line of treatment in the form of eye drops( either one or more eye drops). If these fail after 6 months or if the extent of vision and visual field loss has been more, the second line fo treatment is tried in the form of laser trabeculoplasty. If this also fails after repeated procedures then trabeculectomy surgery is tried.


 

Dr. A.S. Desai :

If trabeculectomy also fails the setons are tried.


 

Dr. A.S. Desai :

I hope this gives you a clear picture about how glaucoma treatment is planned. If your doctor has suggested insertion of a tube then I guess you can just clarify as to why it has been suggested.


 

Dr. A.S. Desai :

Your surgeon would be a better person to take a call on the modality of treatment but you should feel free to ask if there is any role for laser treatment/trabeculectomy before considering insertion of the tube.


 

Customer:

Well my Doc says I was developing glacoma from all the steriod drops I've been on is Prep Forte


a steriod


 

Dr. A.S. Desai :

Yes , he could right as steroid are known to cause glaucoma( as I mentioned earlier- steroid induced glaucoma).


 

Dr. A.S. Desai :

But the treatment would still be the same as mentioned above.


 

Customer:

Would this laser be an effective treatment, I've been on these drops for about 8mths now. some days my eye is pretty clear and some very cloudy

Dr. A.S. Desai :

Since you have cloudy vision, I wonder if it is due to haziness of the cornea ( you mentioned about having undergone lamellar keratoplasty-partial thickness corneal transplantion). Laser treatment is definitely difficult to perfome in case of hazy cornea.


 

Customer:

oh so I guess maybe he knows what he's doing


 

Dr. A.S. Desai :

Yes, looks like that. I am sure he must have considered all these factors before concluding on the type of surgery best suited for you.


 

Dr. A.S. Desai :

So all the best for the forthcoming surgery!


 

Customer:

well he never mentioned a laser surgery

Dr. A.S. Desai :

Probably he would have noticed a hazy cornea which made him realise that laser would be difficult to perform) a clear cornea is a pre-requisite for lasers).


 

Customer:

Well every visit I had with him he always said the cornea looked clear from his side, but it was always cloudy from my side


Maybe he put it in backwards Ha,Ha


 

Dr. A.S. Desai :

Not sure about that!! Haven't seen cornea.... But you could as well ask if he has ever considered laser in your case.


 

Customer:

Sounds better than going through surgery, does a laser treatment have a lasting effect on your eye. He's told me I have to take about 1 week off work after the surgery

Dr. A.S. Desai :

Effectiveness of lasers would depend on a few factors such as how pigmented your trabecular meshwork is, clarity of the cornea. Though not a permanent cure in all cases it is definitely a good alternative to surgery.


 

Customer:

How about this tube well it be permittly in my eye


 

Dr. A.S. Desai :

Yes it is a permanent mode of treatment.


 

Customer:

well it be bothersome, or plug up


 

Dr. A.S. Desai :

It is inserted inside the eye and well covered above. You not be able to feel its presence and nor will it be bothersome.


 

Customer:

even if for some reason I rub my eye


 

Dr. A.S. Desai :

even then you will not feel it nor will it move.


 

Dr. A.S. Desai :

Getting late for work( I am on call duty today.....it is morning in this part of the world). We can continue to interact if you are still left with some more questions.


 

Dr. A.S. Desai :

Please feel free to ask follow up questions if any.


Thank you and best wishes.

It was a pleasure to have answered this question.

A positive rating is what I aim for and we can continue to interact till you get a satisfactory response.A positive feedback and /or bonus are most welcome and appreciated.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist



 

Dr. A.S. Desai :

http://www.glaucoma.org/treatment/glaucoma-implants.php . For more information you can visit this site.


 

Dr. A.S. Desai and other Eye Specialists are ready to help you