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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10608
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My opthamologist suspects that I might have glaucoma. My pressures

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My opthamologist suspects that I might have glaucoma. My pressures are 14 and 15. He isn't sure if I should start with eye drops or not. If my pressure isn't very high is there another reason that I may have optic nerve damage?

Dr. Rick :

Hi. I'm happy to help you this evening.

Dr. Rick :

Were you seen by an ophthalmologist (Eye MD) or an optometrist?

Dr. Rick :

What other tests did the eye doctor do?

Dr. Rick :

Do you have any medical problems or take any medication?

Dr. Rick :


We have been experiencing problems with the chat system for the last few days. Our engineers are working on it. However, I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

Customer: replied 3 years ago.

I saw an eye MD. He did a field study and checked the pressure in my eyes. I had these test done last week and 6 months ago and there is no change.


I don't take any medications or have any health issues.

Thank you for that extra information.

The pressures you have reported are well within the "normal" range of 10 to 21 mmHg. That being said, if your ophthalmologist is finding evidence of nerve damage and visual field changes consistent with the diagnosis of glaucoma, or "glaucoma suspect" then you may be suffering from a disease called "low tension glaucoma"

In the most common form of glaucoma (primary open angle glaucoma) the intraocular pressure is elevated above normal. In some cases the eye pressure is never found to be above 21mmHg even though there is clear cut evidence of glaucomatous damage.

Unfortunately, the only way we know how to treat glaucoma -- even low tension glaucoma -- is to lower the eye pressure. As you might imagine it can be very difficult to get the eye pressure low enough to stop the progression of disease if the pressure is already "low/normal"

I am glad to hear that your repeat testing has showed no further evidence of disease. With your diagnosis, I can not stress enough the importance of careful followup with your ophthalmologist as this is a silent and blinding disease.

Should you have any concerns it might be useful for you to obtain a second opinion from a glaucoma specialist.

To answer your question directly: Yes, there are other causes of optic nerve damage but it would be unlikely that your ophthalmologist would not rule them out before diagnosing you with low tension glaucoma or glaucoma suspect. Also, the morphology of optic nerve damage and visual field changes found in other forms of optic nerve disease are usually very different.

Does this answer your question to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick

Have a Happy and Healthy Holiday Season :-)
Customer: replied 3 years ago.

Thank you for answering my question. The information has been very helpful. I do have one more question not related to glaucoma. Do eye creams or drooping eyelids have an effect on vision or cause damage.

No. The vast majority of over the counter eye creams like you are talking about will not have any adverse effect on your vision or cause any damage.

That being said, they usually don't help with drooping eyelids much either :(
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