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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11409
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I recently underwent laser surgery for glaucoma in both my

Resolved Question:

I recently underwent laser surgery for glaucoma in both my eyes. Today I had my post surgery follow-up and the doc said that everything looks fine and that the laser was a success except that she is still worried about the pressure being too high (23 in both eyes). So she said I will need to do two more tests to determine what is causing the high pressure and whether I have a mixed glaucoma! My understanding is that the laser surgery was going to lower or correct the pressure in my eyes but she said that it was only to prevent it from worsening? I am not sure that I understand this and would like you to explain to me the role of laser surgery in glaucoma and the HRT3 test which I am scheduled for next week and what kind of findings and managements should I expect for my glaucoma. Thank you so much
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.
Dr. Rick :

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

Dr. Rick :

Do you know what type of laser surgery you had? Was it a LPI, ALT, SLT?

Dr. Rick :

The HRT3 test is a computerized "picture" of the anatomy of your optic nerve. It helps to find changes that may be suggestive of damage to your nerve that could be from your glaucoma. Here is a very good article on this instrument:

Dr. Rick :

Dr. Rick :

Also, do you know what your eye pressure was before the surgery? Have you had a visual field test done (stick you head in a dimly lit bowl and press a button as lights flash around your visual field)?

Dr. Rick :

I see that you are offline. 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..... :)

Expert:  Dr. Rick replied 5 years ago.
I'm still here and looking forward to your response so that we can continue to work on your question. The more information I have the better I can discuss what you can expect in the management of your glaucoma.
Customer: replied 5 years ago.

Hello Dr. Rick

Thank you for your reply. No I don't know what my pressure was. I guess the Dr. should have given me the before and after pressures. No I did not have the visual field test done. What is this for? I am not sure what kind of laser surgery I had. They put a few drops in my eye before and I was seated as if I was doing an eye exam. Thank you

Expert:  Dr. Rick replied 5 years ago.
Ok. Well, a visual field test is a very important part of any glaucoma workup and treatment. The most common test is with the Humphrey system, although there are other models out there.
As I noted above, there are many types of laser surgery for glaucoma, depending on the type of glaucoma you have (narrow angle, angle closure, mixed, open angle,pigmentary etc)
It does sound like you are getting good care with this doctor and as you already know glaucoma is a chronic disease that, while it can not be cured, can be managed in a number of ways.
Many people who have laser treatment for glaucoma also will need to use drops to continue to control their eye pressure.
Does this make sense to you?
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Customer: replied 5 years ago.

thank you for the reply once again. I am not on any medication. Should I be on any right now? It has only been 2 weeks since my laser surgery and my pressure was at 23 yesterday, should I expect it to go down in the coming weeks?

Expert:  Dr. Rick replied 5 years ago.
A pressure of 23 is not that high, normal being between 10 and 21, however it depends on the status of your optic nerve and other findings if this pressure is too high for you. Your doctor will let you know if you need drops to lower the pressure at this point....every patient is different.
Without knowing what type of laser surgery you had I can't tell you what to expect in the coming days. This would be a good question to ask your ophthalmologist.
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