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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11357
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have pigmentary Glacoma for many years now. I am 37 years

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I have pigmentary Glacoma for many years now. I am 37 years old and i was diagnosed about 7 years ago. On diagnosis i had already lost some field vision in my right eye. I take timolol in both eyes twice a day and xalatan in my right eye in the evenings. About 6 years ago i was cycling to and from work about 7 miles per day when i noticed a lot of fogginess in my right eye during and after riding, also i would experience the fogginess when waking up in the mornings. I went to the eye hospital and my pressure had risen in my right eye to 28. The doctor was quite surprised this had happened and told me cycling is usually okay. They gave me lazer treatment in the eye to improve the drainage. This sorted out the problem. Since then i haven't really done much excessive exercise until recently . As i suffer from headaches a lot, regular cycling really helps to relieve my symptoms and acts as preventative measure. I understand activities like jogging and high impact sports aren't very good for me. I love cycling though and it isn't high impact. I really want to get into a regular cycling routine again but i am a little nervous. I got into swimming a while ago and sometimes after a good swim I would get a little cloudiness in my right eye but not to the same degree i had before my lazer treatment. Sometimes my right eye would feel a little gritty for a very short time after swimming but when i went to the hospital a couple of weeks later my pressures were fine in both eyes and the doctor told me he didn't think i need to worry so much and it should be okay to carry on with my swimming. The doctor could see i was worried about exercising and gave me some tablets to ease my fears to take straight after after exercise called Diomox (Acetazolamide). I tried taking them a few times but they just make me feel drowsy and i prefer not taking any tablets if possible. I have heard of taking pilocarpine eye drops before exercise. Can i get these prescribed by my doctor? Is it okay and is it normal after exercise to experience a little fogginess now and again for a minute of two? Please be so kind to give me your thoughts on these matters?
Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : The laser surgery your doctor did in the past might have been either a laser peripheral iridotomy or, perhaps, argon laser trabeculoplasty. Both of these are known to work will with pigment dispersion syndrome and pigmentary glaucoma.
Dr. Rick : In my opinion, you can ride your bike to exercise without much risk.
Dr. Rick : Since you do not like the side effects of oral diamox you could use a drop called Azop. This drop contains a medication in the same class as diamox and should help prevent or dull any pressure spikes you may get secondary to the pigment dispersion that might occur with exercise.
Dr. Rick : I think you will tolerate the azopt better than pilocarpine....
Dr. Rick : Pilocarpine not only makes your pupil really small, but it can cause brow/headache as well.
Customer: should i ask my doctor for the azop?
Customer: i prefer drops with the least side effects if possible
Customer: what about the little bit of cloudiness every now and again?
Customer: is this anything to worry about or just normal?
Dr. Rick : Yes. Your ophthalmologist could prescribe azopt for you. He might even have free samples you can try.
Customer: Is it okay like to cycle for 4 hours. a really good session?
Dr. Rick : The little bit of cloudiness could be from many issues. As long as your optic nerve does not show any progression of glaucomatous damage and your visual fields are unchanged along with your nerve fiber layer, I think you will be ok.
Dr. Rick : Of course, one thing that you have to think is that the cloudiness is secondary to elevated IOP...but, from what you have posted, I think you are OK
Customer: ok great thanks for your help today. brilliant
Dr. Rick : Try it.....if you have problems, see if you can get your IOP checked when you are having symptoms and/or right after you get off the bike from a good ride (this can be easily done with a tonopen)
Dr. Rick : My pleasure. I wish you the very best. Enjoy the summer :)
Customer: tonopen?
Dr. Rick : 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. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.Thanks in advance,Dr. Rick MD FACS
Dr. Rick : looks like a pen but costs $3,000
Customer: haha i need to save up for that!
Dr. Rick : It is a very accurate way of checking eye presssure without the blue light and drops
Customer: i will try my opticians
Dr. Rick : But your eye doc's nurse could check your pressure in the waiting room with it.
Customer: ok thanks
Dr. Rick : I think they have them in the UK....I have 4 in my office here in the USA :)
Dr. Rick : My pleasure. Always happy to help a friend from across the Atlantic Ocean.
Customer: cheers ***** ***** a good day!
Dr. Rick : you too!
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