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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11414
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My 54-year-old brother-in-law has had both detached retinas

Resolved Question:

My 54-year-old brother-in-law has had both detached retinas repaired in the last 2 years. His sight is decreasing, however, and has had several diagnoses, one of which is low-pressure glaucoma. Could this be a result of the surgery (not looking to sue, don't worry!)?
What is the long-term prognosis for this? Will it continue to get worse until he is completely blind? I did get one answer, which was unsatisfactory but might be the only one available: "Not much is known about glaucoma."
Can someone take a crack at this problem and give me a bit more info.?
Marianna
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.
Dr. Rick :

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

Customer:

Dear Dr, Rick, Do you have any off-the-cuff opinions and/or knowledge about this condition? I have suggested that Rolf (my brother-in-law) go to the Wilmer Eye Clinic here at Hopkins. Is that a good idea?

Customer:

Maybe I don't know how to work this site, but I can't find any answer and can't seem to get off and come back later...have to go to work.

Dr. Rick :

Sorry about that....we missed each other. You can come back later to this question without any difficulty. We're still working on your question.....

Dr. Rick :

Since you are offline and I will soon we can switch to the Q&A system. In this system we can 'text message' each other back and forth.

Expert:  Dr. Rick replied 6 years ago.
I'm still here and available to work on your question. We each will get an email notification when the other has posted a thread to this page.
As I understand your question, you are interested in more information on low tension glaucoma and the past retina history is not at issue right now. Is that correct?
Customer: replied 6 years ago.
This is correct. I could look it up online, I suppose, but sometimes there's incorrect info. posted out there. And I think Rolf has an unusual visual history, what with the detached retinas and all.
Expert:  Dr. Rick replied 6 years ago.
Hi. I'm online right now.
Expert:  Dr. Rick replied 6 years ago.
Low tension glaucoma is a well known subset of the types of glaucoma. In this condition there is the typical glaucoma damage to the optic nerve, visual field and vision that is seen in patients with elevated pressure, however, even with careful and frequent measurements, there is no increased eye pressure ever seen.
Expert:  Dr. Rick replied 6 years ago.
When it comes to glaucoma, ophthalmologists are like the guy who only has a hammer and therefor thinks everything is a nail. The only way we know to treat glaucoma is by lowering the pressure. Sure, we have a lot of different ways to lower the pressure, but when it is all said and done that is all we do.
That is the problem with low tension (also called normal tension) glaucoma. The pressure is already low and things are going downhill. So. What to do? You got it. Lower the pressure!
Expert:  Dr. Rick replied 6 years ago.
It is a balancing act in this disease to lower the pressure enough to stop progression of the glaucoma damage while avoiding the complications of hypotony.
It is usually a good idea to have low tension glaucoma managed by a glaucoma specialist. That way you know that you are getting the best treatment available.
Does this make sense? Any other questions?
Expert:  Dr. Rick replied 6 years ago.
I reviewed your prior posts and noticed that the doctor who told you
"not much is know about glaucoma" was a GP. Well. I don't do heart attacks, but that doesn't mean that not much is known about them... :o)
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Expert:  Dr. Rick replied 6 years ago.
My system shows you are online. Are you there?
Expert:  Dr. Rick replied 6 years ago.
To answer your question about Wilmer: Yes. They are one of the best eye clinics in the world.
Dr. Rick and other Eye Specialists are ready to help you