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I had an eye exam by an optometrist. She said my cup to disc…

I had an eye...

I had an eye exam by an optometrist. She said my cup to disc ration was 0.6 in one eye and 0.5 in the other. 3 years ago, they were 0.3 and 0.25. The pressure in each eye was 21. But she said my corneas were thick: over 606 um, so my pressure was around 16 in each eye. My vision has decreased (added 2.00 + to my readers). Am I at risk for glaucoma? I am 50 years old with no family history and no medical issues)

Doctor's Assistant: When was the last time you had your eyes checked? In general, how has your vision been lately?

I had them checked Friday, 1-13-16 and this is when she told me this. Prior exam was 2013.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

1-13-17

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Customer reply replied 1 year ago
She said I could just come back in a year and have my eyes checked, but I am worried about the cupping she saw in my ONH. 3 years ago she said there was no mention of cupping (I have not seen the optometrist since 2013 until this past visit on 1-13-17.). She said I am farsighted and have thick corneas so that makes me have less risk of glaucoma, but I am thinking of going to an ophthamologist just to be sure. Does this seem like a glaucoma change? I take no meds and I do not have HTN.
Answered in 6 hours by:
1/15/2017
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,131
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Hi. I'm Dr. Rick and I have two decades of ophthalmology and retina surgery experience. I'm online and happy to answer your question today.

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High blood pressure has nothing to do with high eye pressure/glaucoma.

What your optometrist is telling you about your cup to disk ratio changes is significant.....it if is true.

You do not mention if you had any visual field tests done....

In any event, to answer your question:

Yes. It is very important that you gather up your optometrists records and see an ophthalmologist in the very near future for a complete exam.

I, personally, would not just say "come back in a year" if I noticed a cup to disk ratio change like your optometrist has so casually discussed, no matter how thick your corneas might be.

This needs to be followed up by an Eye MD as glaucoma, left untreated, is a blinding disease.

Does this make sense to you?

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the excellent feedback button for this encounter. And, don’t forget, I work for tips. I would also be happy to continue to answer any more questions you have until we have resolved your concern.

Dr. Rick MD FACS

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Customer reply replied 1 year ago
Is the cup to disc ratio the worst sign that I could have glaucoma? I had to get my reading glasses adjusted but my far vision is unchanged. She did some peripheral field tests (wiggling fingers) and it was fine. Can there be glaucoma with normal IOP? At first she said my pressure was 21 but then said 16 after doing a pachymeter córnea test. Should I avoid anything like massages lying prone? I plan to schedule to see a specialist.
Customer reply replied 1 year ago
One other question.
Can Botox cause any visual changes or anything like this? I went to an MD for injections of it and this started 2 years ago.
Customer reply replied 1 year ago
Can I drink coffee in the morning or should I avoid caffeine?

Let me go over your new questions in order:

1. Cup to disk ratio is but one sign of glaucoma. There are many more. Glaucoma is a blinding disease and, in my professional opinion, should never be managed by an optometrist...even if the State Licensing Board gives them the right to do so....

2. Wiggling fingers is not a sufficient test for visual field loss in glaucoma.

3. Yes. Pressure can be in the normal range and still have severe, blinding glaucoma.

4. You can have massages in any position....and do see an ophthalmologist ASAP.

5. No

6. Caffeine and coffee does not have anything to do with glaucoma...which we don't even know if you have yet. Drink away ;)

Make sense?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS

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Customer reply replied 1 year ago
OK. Last question. Could Adderall affect pressure in the eye? I only take a low dose (7.5 mg once or twice a day).

No. It adderall will not change your eye pressure at all. No worries there.

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 can please give me the top rating in all areas. It has been a pleasure to assist you today.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,131
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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