Glacouma

[Fanen]

I have open angle glacouma. I need the best eye drop for this. No much improvement with timolol and brimonidine. Any help?

[JanD236]

This is something your specialist should advise?

I’m on monopost and cosopt which my specialist describes as ‘maximal medications’. They did bring my pressures down further than other combinations.

[Fanen in reply to JanD236]

Thanks JanD236, but for two months now my specialist and others are on strike.

[JanD236 in reply to Fanen]

You’ll need to see some sort of specialist to have your pressures taken and to do a fields test? Mine were always closely monitored so that the specialist was in a position to decide whether or not changes to meds were needed.

[Fanen in reply to JanD236]

Ok. I just have to. Thanks again.

[HMThai in reply to Fanen]

Hi from Thailand,

Do you know what was IOP Eye pressure ready are?

When you were diagnosed did you have a full Eye examination including Gonioscopy and Visual Field?

When you wrote there wasn't much improvement what specifically did you mean and how do you know?Your Glaucoma Specialist must explain what is ahead!

Remember always to do Punctual occlusion (look it up ). This is very important! Also rinse your eyes 10/15 minutes after inserting eye drops,this will prevent dry eyes in the future... periodically use preservative free Lubricating eye drops like Tears of Systane...

[eyesong in reply to HMThai]

Hi HMThai, I appreciate your advice on both punctual occlusion and also I am curious about rinsing after using eye drop medications for my Glaucoma 15min. or so after use. The use of many Glaucoma medications especially with preservatives I know will cause problems with surface eye disease eventually. No one has told me to rinse and I always wondered how long it takes for the medication to take effect. Let me know more about this procedure. Thanks for your tips, Eyesong .

[HMThai in reply to eyesong]

Good morning from Thailand

Here is an extract from Glaucoma.org

Is there a “best technique” for getting my glaucoma medication eyedrops in my eyes?

There are two issues with getting the eye drop where you want it: inside the eyeball. The first is getting the drop from the container onto the surface of the eye. The second issue is getting the drop from the surface of the eye to the inside of the eye where it will work to lower the eye pressure.

First, you will increase the chances that a single drop hits the eye if you lie down flat with your face up. Only one drop is needed, not two, even if the bottle says, “one drop or two.” Gently pull your lower lid down to increase the amount of eyeball showing, bring the bottle about an inch above the eye surface (hold the bottle as vertical as possible), then gently squeeze the bottle until you see or feel the drop hit. Be careful not to touch the bottle to your eye as this can transfer bacteria to the bottle tip.

Next, to maximize effectiveness and minimize systemic side effects, use the 2-minute eyelid closure technique combined with closure of the tear drainage system:

eyedrops_290.jpg

Once the drop is on the eye, do not blink your eye or move it around to spread the drop. Instead, gently close your eyes just once, place the pad of your most sensitive finger at the inside corner of the eyelid by the nose and press gently.

Leave the eyelids closed and the finger pressing gently for 2 full minutes. Studies have shown that it takes 2 full minutes for the drop to completely penetrate the surface of the eye to get inside. Put the cap back on the bottle, with eyes still closed. The closed eyelids and pressure on the tear drainage duct avoids unwanted systemic side effects from the potent eyedrop drugs by preventing the drop from getting inside the nose where it could enter the bloodstream rapidly.

After two minutes, the drop is fully absorbed into the eye. You can now put a different drop in, if you use more than one drop.

When I said rinse, what I meant was to splash water on the eyes with them closed and wash away the residual of the medication which is on the eye lashes!!..... Before going to sleep I put tiny bit of virgin coconut oil with my little finger on the eye lashes, don't worry,I have been doing this for a long time now, also in the mornings, again dab a little warmish water on the eye lashes..(With eyes closed!!)... Very refreshing I assure you!

[Fanen in reply to HMThai]

Thanks so kindly. I shall try using the method as recommended. Wish i was in th

[eyesong in reply to HMThai]

Thanks for your advice! I wish I had known to wash the residue off my face earlier as my drops darkened the color of the skin all around and under my eyes. Now I wash my face after using my drops. I like the idea of coconut oil as it is good for the lashes and probably for dry eyes at nite too! I have a question for those using Cosopt PF , I have extreme burning for several minutes with these drops and I wonder if it is typically the way they work. I use Zioptan at night and not so much pain with it. Thanks, just curious. Eyesong

[HMThai in reply to eyesong]

I was going to reply earlier,then forgot about this,as we do! 😂ok so your Cosopt PF is called the 'bulldog' in the eye medications, Meaning if it cannot reduce the eye pressure, then you need advice!I searched and there are many alternatives to Cosopt available,but my opinion is first try using Vislube drops(wait for a few minutes) before using Cosopt PF.Make sure you do the punctual occlusion correctly,I know it is boring, just lie down,chill and do some gentle deep breathing whilst lying down.About the coconut oil, ensure it organic. Good Morning ☀️ from Thailand!

[Windflower in reply to HMThai]

I have found this information very helpful. Wish I had known about this a few years ago. Thank you for your advice which seems clinically correct.

[HMThai in reply to Windflower]

You are welcome!I have been doing this for many years! Good Morning from Thailand!

[Trish_GlaucomaUK Partner]

Hello Fanen,

If the eyedrops you are using are not controlling your eye pressure then the consultant will have to address this and prescribe you an alternative drop. They would normally try up to 4 different drops but if none of these work in controlling your glaucoma they will look at other options which are laser or surgery. Once glaucoma is diagnosed, the damage done cannot be reversed but can be controlled.

[Fanen in reply to Trish_GlaucomaUK]

Thanks for the response. Public hospitals (doctors)are on strike at the moment , i just have to continue with the prescription while waiting for the strike to be called off.

[Fanen in reply to Trish_GlaucomaUK]

Appretiated

[HMThai in reply to Trish_GlaucomaUK]

These days the Glaucoma Specialists ought to be moving away from Eye medications towards lasers (SLT) for the first line treatment for the Primary Open Angle Glaucoma.There is enough evidence that the SLT is more effective and less costly.I personally still have to use 2 drops as my SLT hasn't worked until now, having had Laser Iridotomy done already!I would love to give my Eye drops,I asked my GS if Laser Iridoplasty was an option,she didn't think so !, said we can discuss on my next visit! Good day from Thailand to you Trish!

[Trish_GlaucomaUK Partner in reply to HMThai]

Hello HMThai. Good day to you too. When a person is first diagnosed in the very early stages of glaucoma, SLT may be suggested rather than prescribing eye drops. This procedure can be repeated up to three times. If, however the eye pressure is still too high they will be prescribed eye drops. Not all patients, even those diagnosed in the early stages will be offered laser. Every patient is different, so different decisions are made in regard to the best form of treatment for them.

[HMThai in reply to Trish_GlaucomaUK]

How true Trish,in my case also,it doesn't seem to have worked so far,so for now I continue to use drops!I will be popping into my Opthamologist for a quick check up to see if all is functioning well.Yesterday my 20/20 vision chart arrived at home here in Thailand,so I can do my own testing, just for fun!😂 Good day to you from Thailand, visit sometime!

[Hidden]

A year ago I was prescribed xalaTAN eye drops, and & the pressure in my eyes has slowly gone down from 20 & 22 to 14 & 16.

Hope this helps

[Fanen in reply to Hidden]

Thanks overend. I hope to get the best from it