Astma and glaucoma

I have asthma and glaucoma. Using the preventer inhaler increases my intra ocular pressure and leads to more damage of the optic nerve. My glaucoma is already near the fixation point and difficult to treat. Not using the preventer inhaler will damage my lungs due to inflammation and increase the likelihood of an asthma attack. My ophthalmologist and my GP have not come up with any advice and leave it to me as to what I do. I'd be very grateful for any advice.

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  • Hi there, firstly I would say it is worth looking at any tweaks that can be made to improve your asthma, to perhaps lead to a reduction in medication. HEPA air purifiers are a help; hard floors; a good vacuum cleaner etc.; dietary things if you might be better without wheat and dairy (popular suspects).

    I take symbicort on a 'when needed' basis, which these days is rare but I had been on a high dose daily for a decade until my symptoms began to improve after I moved to a flat with hard floors and became obsessive about dust, I don't think it was a coincidence although I know all factors including age are hard to know for sure.

    Check you're administering eye drops effectively.

    Dietary addition should include beneficial greens and blues, and probably the other colours of fruit and veg too.

    There are supplements that are said to help ocular pressure, although NHS surgeons will say if they worked they'd prescribe them, but I think they may be biased. iCaps used to be prescribed for AMD I think.

    One specifically aimed at eye pressure is by 'life extension' and contains French maritime pine-bark extract and, (I think), bilberry.

    Apparently several eye conditions can be benefitted by the same antioxidant vitamins and minerals because of 'physiological pathways' (I'm a layman btw) being shared.

    Lutein and zeaxanthin are in most eye health supplements, they are sourced from bilberry (related to blueberry) or marigold, so if you're allergic to marigold,the bilberry option is fine.

    iCaps and other products contain these things along with the vit C & E combo and zinc and selenium.

    Saffron is touted as great and there is a us patented formular called saffron 20/20, uk pat pend.

    Many eye problems are linked to smoking (I reckon passive smoking too) and so these supplements contain vitamin A instead of the dreaded beta-carotene (a cancer concern in smokers).

    Bleeding/clotting issues and blood pressure can affected by some supplements or high quantities of some of the blue and red fruit and veg., so that's something to bear in mind.

    Along with WebMD, I look at examine. com. I researched a bit about these things for my parents. My dad had a cataract op to reduce his pressure last year, however, since then his pressure has dropped within the normal range in both eyes not just the damaged one that he had the op on. They can't account for the improvement but I notice two things- his overall health/stress level has improved and he began taking iCaps, around the time of the op, seven months ago. He may have been using his drops better though.

    I hope things improve for you.

  • Thank you very much for your informative and detailed reply. I will follow up your suggestions.

  • Thank you.

  • I can't tell from your post whether the sharp breath you take to inhale from the inhaler increases the ocular pressure or whether it is the drugs themselves.

    If the drugs then I would insist on being referred to check into what drugs you can have for the asthma which doesn't or limits the impact.

    If its just the act of taking the inhaler (and not the drugs itself), then I would ask, are you using a Spacer to get the medication? If not, may I suggest you try that. You can pump the inhaler into the spacer and use natural breathing (rather than the quicker breath you need for the inhaler direct) to gently take in the drug.

    As you will be more naturally breathing it in (short gentle breath through the mouthpiece and repeat until you hear the "whistle" in the spacer which says the drug is all been taken) should hopefully not put increase ocular pressure as you will be doing what you normally do when breathing.

    Spacers are available from pharmacists and online.

  • Thank you for your informative reply Elisabeth. I have already been down that particular road and I am using a spacer too. It is actually the drugs that cause the increase of the intra ocular pressure. However, I have since been advised to ask for a referal to a pulmonary specialist. He/she may be able to give advice about the dosage and drug which may affect the eye pressure not so much.

  • You are very welcome. Sorry I couldn't be of any help.

    Hope you can find a good specialist and get the issue resolved.

  • Hi, I am on Symbicort for the last six months. My intra ocular pressure has been found to be on the higher side (about 25 mm hg). Unfortunately Symbicort is a powder inhaler and as such cannot be taken with a spacer. I am at a loss about my course of action. I can understand the dilemma of ingemaria.

  • Thank you for your comment. I am sorry that your IOP has increased. Ocular hypertension is defined by an eye pressure greater than 21 mmHg. How this IOP is interpretated depends on other aspects of your eyes like for instance the thickness of your cornea. I think that the best course of action is to consult an opthalmologist (referral through GP in the UK) and ask him/her about your asthma medication. It is also a good idea to get a referral to an asthma specialist and consult him about more suitable medication to take in to account your raised IOP. Kind regards.

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