Hi IOP after eye injury. : Hi, new to the forum... - Glaucoma UK

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Hi IOP after eye injury.

Sim_L profile image
32 Replies

Hi, new to the forum and Glaucoma in general. I'll tell you my story in the hope of a bit of reassurance.Exactly 6 days ago I had a pretty severe blunt injury in the left eye. Resulting in an internal bleed, partial iris detachment, abrasion and now pretty high eye pressure. I'll be honest I'm pretty scared of the possibile outcome.

My IOP has been as high as 50 and I'm on 6 different medications. My vision in the left eye is completely clouded over. I still have a visible clot in the front on the eye and my pupil is no longer round.Is the vision loss due to the pressure or the build up of fluid? My specialist is currently just trying to keep the pressure down long enough until the eye clears and regulates itself. I'm scared that there is already too much damage done by the pressure to get any kind of usable vision back.

Any help please 🙏

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Sim_L
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32 Replies

Hello.

I am so sorry for what you have been through.

I had an eye injury (L) in 2012, something in eye as I was walking on a windy day. My pressure used to high with maximum medication for both Uveitis and Glaucoma. I had to have a Baerveldt shunt done in Dec 2013 and now my Uveitis and Glaucoma are controlled. I am on Maxidex once a day and Azarga (for Glaucoma) twice a day.

I also had a Cataract done 2018 as a result of using steroid drops for Uveitis.

Good luck

Sim_L profile image
Sim_L in reply towarwickshire_singh

Hey thanks for the reply. I hope that the pressure comes down and the eye starts draining soon, I'm back in early tomorrow, perhaps because they need to decide if they are to operate or not, I'm not sure

warwickshire_singh profile image
warwickshire_singh in reply toSim_L

My experience is a horror story, but that doesn't mean yours will be too, but thanks to Birmingham Midland Eye Centre (BMEC) and Mr Velota Sung I am now okay.

Let us know how you get on and what they say.

AlfredV profile image
AlfredV in reply towarwickshire_singh

Mr Sung is a superstar. Sorted me out while others were scratching their heads.

warwickshire_singh profile image
warwickshire_singh in reply toAlfredV

That's so brilliant to hear!

As far as I am concerned, the man is a living God! I went to him in Sept 2013 on 6 tablets and 8 drops a day, now on 3 drops a day!

Also the man who did my Uveitic Cataract in 2018, he was amazing too!

Cornwalleyes profile image
Cornwalleyes

That sounds awful, but you have to be patient. It needs time to recover and settle back down. I think as long as they are treating the high pressure until your eye recovers they are doing a good job and you frustratingly will just have to wait and hope that when it recovers your vision is back to normal. It’s damage to the optic nerve in glaucoma that causes sight loss and that’s caused by the pressure in the eye. Hope all goes well.

Sim_L profile image
Sim_L in reply toCornwalleyes

Thank you for the reply, they are unable to see the optic nerve atm the moment due to the cloudiness, although they did an ultrasound and that looked ok

Bellamolly60 profile image
Bellamolly60 in reply toCornwalleyes

spot o with the advice

MatthewC profile image
MatthewC

Hi Sim,

I had severe blunt injury to my right eye in June this year. Total hyphema causing vision loss/cloudy vision plus high pressure (30s and 40s, occasionally measured at 60+).

The good news is that 6 months on my vision is almost back to normal.

Immediately after the injury the treatment was pressure reducing tablets plus sitting upright to let the hyphema drain. It took a few days to drain, but blurry vision eventually returned - pressure didn't come down though. I had been really worried the vision was gone, and the Drs were a bit vague about prognosis in those early days (a lot of 'let's treat the immediate thing and see where we are'), which was worrying but ultimately the vision came back.

My pressure continued to be a problem, short story is that they decided the trabecullar mesh work had been damaged (the drainage in the eye) so they did a trabeculectomy after about 2-3 weeks of waiting in vain for it to heal itself. I've now got normal pressure again.

My pupil remains dilated and occasionally misshapen from the trauma, but to be honest it's not something that bothers me particularly - it causes slight burry vision but not much.

Those early days and weeks are scary. What worked for me was asking lots of questions and doing research to try to understand how it was all working (or not working!) and the benefits /risks of treatment options.

I was on intravenous mannitol in the early days to keep the pressure down - if your pressures are really high I don't know whether that's been considered?

Re the optic nerve damage, it makes sense that you're worried - I was too! But it's something they're not going to know until the pressures calm down and they've sorted that. You're relatively young so finger's crossed for you that it's OK, as it seems to be for me.

Best of luck.

Sim_L profile image
Sim_L in reply toMatthewC

Hi Matthew, thanks for the reply. You are right they are still keeping any outcome explanation a bit vague but I suppose that is because they don't know for sure. They have mentioned my meshwork is probably blocked with blood. IV was talked about but I seem to have responded well to acetazolamide tablets and Iopidine drops. I'm also on Dorzolamide, timilol, latanoprost. Also atropine (Dilating), which is confusing for me as the datasheet says don't use if you have drainage issues as it can make it worse? I have asked about this but been told its fine

MatthewC profile image
MatthewC in reply toSim_L

I was on atropine too for a few weeks, no-one mentioned the clash with drainage issues and I mustn't have read the data sheet fully for that one!

Good to hear you're responding well to the acetazolomide tablets, I wasn't so lucky. I remember I was on timilol and latanoprost as well.

I had an intraocular washout as they thought my mesh work could be blocked with blood so it's possible they'll try that next. It was only after that failed and the pressure remained stubbornly high that they moved to trabeculectomy.

Sim_L profile image
Sim_L in reply toMatthewC

Hi Matthew, how were the wash out and trabeculectomy for you? how long did each take, were they painful?

MatthewC profile image
MatthewC in reply toSim_L

The wash out was about 30-45 mins done under local anaesthetic. It was fine, not painful although felt weird. There was some pain for maybe half a day post op, it felt like a gritty scratch on the eye.

The trab was done under general anaesthetic for me - it can be done under local but my surgeon preferred general as I was a bit nervous. No problems with pain. The immediate days and weeks post op can be a bit of a roller-coaster for pressure while it all settles down (mine swung to 4 at one day post op, 40 at three days post op!) but the surgeon sees you very frequently during that time. It took a couple of weeks for vision to settle back towards normal and fingers crossed it seems settled now (and has been for a couple of months). The big long term drawback of a trab for me is that I used to be a contact lens wearer and my surgeon doesn't like people to wear lenses post op, so I'm now glasses. Apart from that there are other risks and effects from the op which they tell you all about at the time, but I got the impression it was a relatively safe procedure that's been done for decades and it was really the only option for me.

MatthewC profile image
MatthewC in reply toSim_L

Also I should say that I asked about laser trabecoplasty and laser iridotomy when they were suggesting the trab. The surgeon's view was that they would have been high risk because of the trauma - he said there's not a body of evidence using those procedures in a trauma situation so don't know whether the laser would irritate it all and put pressure up.

AlfredV profile image
AlfredV

Sorry to hear of your troubles. I won't repeat what other replies have said but I can say that your cloudy vision *could* be a symptom of high eye pressure.

From personal experience, above about 35 I would start to see halo glows around light sources, above around 45 my vision would start to cloud over as it causes the cornea to become opaque. Fortunately, as soon as the pressure comes back down the cloudiness and then the halos resolve very quickly.

The worry for me was always that at that sort of pressure, it is likely some optic nerve damage is happening. Hopefully with your docs you get this resolved soon.

Sim_L profile image
Sim_L in reply toAlfredV

Hi Alfred, the optic nerve damage is what is worrying me at the moment. I understand how to pressure would affect the shape of the cornea and vision but would that prevent them from seeing the back of the eye? Or would it be the fluid build up, which also would affect the vision

AlfredV profile image
AlfredV in reply toSim_L

Yes, that could happen. There is a condition called narrow angle glaucoma where the drainage channel can close up, pressure rises quickly and the front of the eye goes completely opaque, occluding the view of the retina and optic nerve. Again, reversible if they are able to open the drainage channel back up and drop the pressure.

warwickshire_singh profile image
warwickshire_singh in reply toAlfredV

This sounds so familiar after my eye injury, haloes around lights and the clouding over, although in my case the haloes were all the time.

Decorator123 profile image
Decorator123

I can’t add a lot to what more people on here have said . But just hope it work out for the best

haraba profile image
haraba

Hi Sim_L,

I am sorry to hear of what you are going through.

I had a direct left eye injury in 2011 and got a hyphaema and retinal detachment. The IOP was 38 mm.(The surgeon repaired the retina with laser and inserted a scleral band around the eye). I was on oral acetazolamide and several drops and the pressure went to under 20 over a few weeks. The vision went from opaque and cloudy to quite reasonable after 3-4 months. I was told in 2011 that the optic nerve may be affected by the pressure and that I would have to be reviewed as it could be many years later.

I have been monitored off and on since and have developed “normal/ low tension glaucoma” in the left eye over 10 years later and have so far been told the right eye ( no trauma)has “ocular hypertension” or “glaucoma suspect”. The pressures were about 17-18.

I started eyedrops- Brinzolamide and Latanoprost this year. Pressures presently about 13-15.(Maybe, I would have developed glaucoma even if there was no history of trauma. I have no known family history of glaucoma). I have monitoring of the visual fields and sometimes retina (OCT), which may become problematical.

Fortunately, I have been able to see reasonably well since the eye trauma of 2011, apart from a slight decrease in colour contrast and brightness in the left eye.

I hope it starts resolving for you soon. Good luck.

Sim_L profile image
Sim_L

Just a little update. Went back to the docs today. IOP at 35 down from 42 two days ago and 50 two days before that. Blood clot in front of eye has reduced in size by around a third since day one so hopefully on the mend. Vision still very cloudy although does clear slightly throughout the day if I rest as much as possible. I pray now that things are going to continue to improve. Next appointment is Tuesday morning

HMThai profile image
HMThai

Good morning from Thailand and so sorry to read this..... Sending hope and warm wishes!.....and a positive outcome!....I just read your good news..... hoping this continues....I shall say a prayer for you...."Om Namo Bhagvato arahoto.... Sangha Sambuddhasa"!

embroy profile image
embroy

I have had Glaucoma after my second cornea replacement, and my Eye pressure went to 70 +, then had to have my eye washed out. I was under treatment in one of the hospital in Nottingham. Like you can't see anything from your right eye, I can't see anything from my left eye. But I do believe in miracles, hopefully I will get my sight back one day, even if I don't get my sight back, I am coping in the best way I can.I have been discharged from the Nottingham hospital, now am under one of the hospital in London, and now have a cosmetic lens, on the left eye, no one tell any difference until I let them know. I feel with the contract lens, have got my confidence back. Feel great in myself.

Sim_L profile image
Sim_L in reply toembroy

Hi Embroy, I'm so sorry for your position Losing your sight is a terrifying experience. Its great that you can stay positive. I hope it all works out ok for you

embroy profile image
embroy in reply toSim_L

Thank you for your encouragement

Jeffvader profile image
Jeffvader

Hi Sim,

Sorry to hear about your trials with your eye. I've not experienced the same trauma that your eye has gone through, my troubles started by getting SLT which sent my pressures through the roof. This message isnt about me, i just wanted to send you my best and wish you well on your recovery. Hope this all eventually sorts itself out, what i do know from my own experiences is that sometimes you need to be patient, which is frustrating at what is a scary time. Have faith that the doctors are making the best decisions for you.

Take care

Sim_L profile image
Sim_L in reply toJeffvader

Hi Jeff, thanks for your words of support. You're right it is very frustrating, today my sight has improved albeit very blurry. I'm still on max medication therapy at the moment but have another review next week. Can I ask what am SLT is ?

Jeffvader profile image
Jeffvader in reply toSim_L

Selective Laser Trabeculoplasty, or SLT, is a form of laser surgery that is used to lower intraocular pressure in glaucoma. Normally is most cases it lowers pressure in the eye, mine went the other way! Due to the high pressure which wouldn't go down, I had to have emergency surgery about 6 weeks ago and am still recovering. My blurriness has started to fade in the last couple of weeks but as my consultant keeps saying to me - "every eye is different".

Sim_L profile image
Sim_L in reply toJeffvader

Ah man, that's so disheartening for you. hopefully when everything settles down the overall outcome will be good. I hate the not knowing of the pressure in my eye, I was being seen every other day but it was decided to leave it for a week and hope the fluid starts to clear. I feel like my vision is improving but very slowly.

Jeffvader profile image
Jeffvader in reply toSim_L

Incredibly frustrating as I know more damage was done during that period between SLT and the surgery. Back and forth to A&E multiple times, am now hoping it's stabilised and life can resume again. Like anything new it's all consuming at the moment and certainly distracting from normal life. Sounds like your vision is moving in the right direction. Agree on the pressures it's always worrying to not know what they are. I've agreed with my optician that I can come down when I feel like it for a pressure test for my own peace of mind, as months between clinical appointments will be worrying

Jeffvader profile image
Jeffvader in reply toSim_L

Also Sim, should you feel concerned in any way go to A&E. After my surgery I went a couple of times as my eye was red and also I was worried about my pressures rising. Both times they were fine and they completely understood me going in. They were happy that I had acted on any concern rather than sit at home worrying about it.

Jeffvader profile image
Jeffvader

Edited as meant to reply to Sim above

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