I had developed an eye floater on my parkie side (right) and I went to the optometrist on March 10th.
The optometrist did not dilate my eye to look at it. She said I had "narrow angle" on my right eye and I had occular pressure and it was unsafe. The optometrist office was to book me an opthalmologist appt to do laser LPI first then she would look at the floater. However, now a pandemic, all elective work has been put on hold and it has not been booked.
The optometrist office said my situation is not urgent and they will get back to it when all is normal but if I see white flashes go to the emergency room.
Last week I noticed I had eye pain and a headache and blurriness at night. I assume it was the "narrow angle" . Since then I cut back my levodopa and I noticed a difference.
Does levodopa increase eye pressure? Should I worry.
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Auro1
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I don't know if taking Levodopa can cause an increase in eye pressure. I have been taking Sinemet for about two years and checking eye pressure every 4/5 months just because my parents have suffered from Glaucoma. For the moment everything is regular.
Levadopa can increase intraocular pressure. Very unlikely you would experience pain as a result. You can use medication to lower the pressure pending surgery (cyclodiode i presume.)
Timolol or cosopt, a prostaglandin as eye drops. Or even diamox tablets. Discuss it with your physician
"Individuals with narrow-angle glaucoma should use levodopa with caution as it can increase ocular pressure."
You do not say whether you have acute or chronic narrow-angle glaucoma, but either way, personally, I would try to find an ophthalmologist who is willing to treat it without delay:
"Acute angle-closure glaucoma is a medical emergency. If the high eye pressure is not reduced within hours, it can cause permanent vision loss. Anyone who experiences these symptoms should contact an ophthalmologist immediately or go to a hospital emergency room.
Some chronic forms of narrow-angle glaucoma, however, can progress very slowly and cause eye damage without any obvious symptoms or pain in early stages."
Some good advice. I'll see what I can do in the current situation.
I assume it is chronic. I don't know.
I've had eye exams almost every year. My eyesight is pretty good with no previous issues. It has been the same eyesight for years.
What changed in the past year since my last eye exam? It is levodopa and hdt b1 and the some other vitamins.
I'm not an expert but I see that narrow angle glaucoma appears to be associated with low acetylcholine. I read on Kia post that higher concentrations of b1 can lower acetylcholine. Whereas he said low concentrations can increase it.
Just as an aside, did the floaters appear at the periphery of your vision. There is the visual hallucination experience we can have of something moving past us out the corner of our eye. I dont know if this is similar to floaters but I think it could be responsive to medication.
A comprehensive article on eye problems in PD. There are neuro opthalmologists in some countries. At the least I hope the opthalmologist knew the effects of PD on vision. I have found some /most don't have a clue.
Hi, I also have been regularly checked for glaucoma because my mother had it. I’m 68 and still testing OK which could be down to diet. Check out Keto Diet - yoursightmatters.com/study-... - seems to work well enabling me to halve my meds - Ropinirole and Sinemet
My husband with PD had glaucoma (was on Sinemet at the time) and laser surgery relieved it. However, his father had glaucoma , too so it might have been genetic.
You have chronic, not acute glaucoma - its been building and observed by your opthalmologist over a period of time. It's caused by a partial blockage of the channels which drain fluid from the eye. Fluid (aqueous humour) is produced by the cilliary body (which sits behind the edge of the iris) and it drains out through the trabecula meshwork (the brown ring on the edge of the iris) into the canal of schlem ( a drainage tube running round the edge of the front of the eye). The aqueous humour performs a cleaning function, and if production and drainage are in balance maintains a pressure on the cornea of between 10 and 16 mgm. Glaucoma is usually due to blocked drainage, but can be caused by excess fluid secretion .(Drugs like levadopa cause increasd eye pressure this way. Dopamine receptors in the eye stimulate production of aqueous humour)
Surgically , the first option was a trabechulectomy , a drainage channel cut in the trabecula meshwork, which lets some of the fluid drain out into the sclera (the white bit of the eye) where it is absorbed back into the bloodstream. I have had its big brother operation known as a barveldt shunt tube, effectively a bit of hose pushed through the sclera into the anterior chamber, which lets fluid flow out. Drug therapy to open the drains is with prostaglandin drops - which will make your eyelashes grow (my wife was very jealous)
The alternative approach is to reduce the amount of fluid being produced. you can use tablets - diamox, which are very effective, but made me feel really ill. I could cope, but life was no fun, and therefore not a long term option. Either beta blocker drops (timolol) or carbonic anhydrase inhibitor drops (dorzolamide) also cut fluid production. Cosopt is a combination of timolol and dorzolamide in one drop. The surgical option is cyclodiode laser surgery which kills some of the cells in the cilliary body to reduce the amount of acqueous humour produced
As a result of a serious trauma from a badminton accident, I've had all that lot (and more) on my right eye. See your opthalmologist! There is plenty he can do if he needs to
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