Glaucoma and Asthma

[Karjade]

Are there many members with glaucoma that also have asthma and take steroid inhalers (preventatives). I am scared that these inhalers are worsening my glaucoma. I have reduced them from 2 puffs twice a day to 1 puff twice a day but nobody seems to know if these inhalers caused my glaucoma. Are there any other members taking these inhalers and what do you think or have been told. Thanks xx

[Ruadh]

Can cause angle closure glaucoma - here is the search criteria - good information, follow the links : inhalers for asthma contraindicated if you have glaucomaYes, I have glaucoma, low tension G., and yes, I have asthma. I refused the inhalers.

[Karjade in reply to Ruadh]

Thank you for your reply. I think I need to speak to my Glaucoma Consultant to see what she thinks. I have normal pressure glaucoma but damage to the optic nerve has progressed which is very frightening. You are very brave refusing the inhalers but I need to speak to my doctor about this before I stop them. I have reduced them which is a good start. Thanks.

[Ruadh in reply to Karjade]

Normal tension Glaucoma / NTG. Damage to the optic nerve : have lost central vision in the right eye, have some peripheral vision, but central, no vision. So, to all intents and good purposes am blind in the right eye. IOPs : Left eye, 8 - 13.5 Right eye, 12 - 15.5 Tried the SLT laser, did nothing for me. On Monoprost, uni dose preservative free glaucoma eye drops. Been on them for several years now; 'No' problems nor unwanted side effects with the Monoprost.

T.G. Passed the tests to continue driving. Inhalants, No. Frankincense, hot water, inhale. Clears my chest and lungs. Can't carry it about with one, there's the rub ! But Frankincense oil, apply to skin on the outside of the throat; a few dabs of the oil. I find that helps.

Check out the info research section I sent you. Make notes. List you questions. Then Discuss with your medical team.

Be well. Take care.

[Karjade in reply to Ruadh]

Your eye pressure is excellent but the damage is still progressing. It is so hard to know what to do for the best. Thank you for all your help and the tips you have given me xx

[Karjade]

I am not on a high dose of inhalers and have cut them down now to half of what I was prescribed. My eye pressure was 16/17 which is normal but my Eye Consultant wants it down even further to early teens so around 13. I was also given laser treatment but still cannot get it that low! I now have to take glaucoma drops three times a day. We have not got an Asthma nurse at our surgery so no real help is available as my doctor does not seem to have a clue! I will discuss with my Glaucoma consultant when I see her again as I need to sort it out before it is too late. Thank you for your reply.

[Tricia3]

I’m also worried especially as I’m now starting to notice a slight deterioration in my vision. I’m doing my best to avoid the steroid inhaler and do everything I can to reduce my asthma triggers but am audibly wheezing at the moment.

[Karjade in reply to Tricia3]

It is really worrying. If we stop the inhalers our asthma will be out of control which is dangerous or if we continue the inhalers our glaucoma progresses and we could go blind. I have reduced the inhalers to what I have been prescribed but my chest is not good and, like you, I am wheezy. Not sure what to do! I will definitely discuss this with my Eye Consultant when I next go xx

[Ruadh in reply to Karjade]

I would concur, discus with the specialists in your medical team. If waiting the time for your next appointment is a longish wait, then would suggest phoning and requesting an earlier appointment. Or, you could send a letter through, or an email, explaining the situation, and requesting a Skype / tele appointment ?Take care.

[Karjade in reply to Ruadh]

I do intend to phone the eye department to request an appointment but they do have a waiting list for appointments. I am also due for a peripheral test and also photographs of the back of the eye. I will definitely chase it up. Thank you.

[Karjade]

Thank you. That is very interesting xx

[Ruadh]

wbiC - Prof (Emeritus) Robert Ritch (glaucoma specialist) recommends sleeping at a raised angle and on ones back. I use several pillows, and sleep on my back. My IOPs, NTG, are generally on the low side : 8 - 13.5 in the left eye, and 12 - 15.5 mmHg in the right eye. IOPs that are too low, and one may end up with poor blood circulation to the retina. Several of the Yoga poses are questionable, Downward-Dog being one such. Also lifting weights - not to be considered especially if you have elevated IOPs.

[Karjade in reply to Ruadh]

I only have one hard pillow and sleep on my left side so total opposite of what I am supposed to do! My pressure does not seem to come down even after SLT laser treatment. My Consultant wants it down to the low teens but I have never had it that low. By reducing my asthma preventatives I am hoping the pressure will come down. I do not practice Yoga or use weights. I wish my pressures were as low as yours even though I put in drops three times a day! Thank you for your help.

[Trish_GlaucomaUK Partner]

It is important that the consultant knows what inhaler you are using, the strength and how often it is being used. Using glaucoma drops (if prescribed) along with the inhaler should balance out and the eye pressure will be controlled and you will be closely monitored. If you need to use the inhalers it is important that you carry on doing this. Any worries or concerns relating to using an inhaler should be discussed with your consultant. It is also a good idea to read the patient information leaflet that comes with the inhaler medication to see if it mentions anything about raised eye pressure or to be cautious if you have glaucoma.

[Karjade in reply to Trish_GlaucomaUK]

Thank you so much for your advice. I am on Fostair 200 and I have reduced it to one puff morning and night from two puffs morning and night. I seem to be okay at the moment and I will see how I go. I have normal pressure glaucoma and my eye pressure was 16/17 but my optic nerve damage has progressed. I have had SLT laser treatment to reduce pressure but I am worried it is the steroid inhalers causing the damage and I did ask my Eye Consultant at the time but she did not seem to know for sure. Truthfully, I am scared and I will try anything to try and reduce the pressure or further damage to the optic nerve xx

[Trish_GlaucomaUK Partner in reply to Karjade]

Sometimes a change in eye drops or being prescribed an additional eye drop can help with reducing your eye pressure. It is not uncommon for SLT to be repeated if need be (up to 3 times) but only if your consultant feels it worthwhile otherwise they may discuss eye surgery. I am glad you are still taking the inhaler as it is needed and I hope you have advised your GP that you have changed the amount of times you use it. If not, it would be a good idea to keep them up to date.

[Karjade in reply to Trish_GlaucomaUK]

I have had SLT three times now so I do not think they will repeat it and eye surgery was mentioned. Within 24 hours I have now got a chest infection! I am taking six Prednisone a day for five days and have no choice as I know how quickly it can get much worse. So much for me reducing the preventatives! I told the nurse I was reducing them and she said it is not the right time to do that now and to increase them again. I will see how I go with the steroids. Thank you xx

[Ruadh]

Jacking up the bedframe, depends on the bed ! For myself, I no longer sleep in a standard 'bed', I sleep in a couch. Supports my spine and ensures a good support to shoulders, cervical spine and so keeps my head well supported - no 'lolling', no divergence out of a good protective position. Sats, pulse and BP, good. I Have used this position for the past 16 years. Prof (emeritus) Robert Ritch is world class, an international figure in the treatment of glaucoma. In addition, his researches are echoed by Prof (Emeritus) Josef Flammer, Berne, Switzerland : Check out the Flammer Syndrome the syndrome named after Prof Flammer.

In addition and of much interest is the good use of supplements in *supporting* the health / well-being of the eye and the retina : Ritch and Flammer. Which is fully supported by the dedicated research by Dr David Richardson, California. A well known glaucoma specialist and glaucoma surgeon.

One could only wish there were more of their ilk in the ophtho world !