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Dr. Stevens
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience:  Board Certified Ophthalmologist
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Should we begin treatment for Normal Pressure Glaucoma

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My wife, 66, myopic (R-5.75, L-5.50), recently had her first eye exam in 13 years. Air tonometry showed IOPs of 17. The opthamologist estimated C/D ratios at R 5-6, L 7, and ordered perimetry. The visual field test showed ZERO LOSS of visual field. Although the doctor did not seem inclined to begin treatment, my wife and I believe that the only possible way to prevent further loss of her optic nerve fibers would be to begin treatment. Our research indicates that for Normal Pressure Glaucoma, the most promising medication is brimonidine (Alphagan P). Would you agree or disagree that it would be advisable to begin treatment, and would you agree or disagree that Alphagan P would be the preferable medication. Thank you very much for any assistance you can offer us.

Hello there

was there any additional testing done, such as an OCT, optical coherence tomography ? Is there any family history of glaucoma?

Customer: replied 8 years ago.
Thank you very much for responding, Dr. Stevens.

No other testing was ordered, or performed.

There is no known family history of glaucoma. Neither parent (both of whom are deceased) had it.

Hi there

I am not convinced she needs treatment. Alphagan P was preferred due to a neural protective effect which has gone out of style last year or two. I prefer Xalatan or Lumigan as it is the best in loweing the IOP. My suggestion is to ask for an OCT of the optic nerves, if the OCT is suspicious then I would suggest treatment. I would also get an HRT at some point and have it for baseline, the HRT often overcalls glaucoma so I dont get it for screening routinely. Dr. Stevens

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