Changes to visual field a year after trabeculectomy

[YoungontheOutside]

I’ve just had my results following a six monthly checkup at the virtual clinic. Whilst my eye pressures are well controlled in both eyes and optic disc, OCT imaging remain stable, the visual field test for the eye that I had a trabeculectomy on last year, suggests possible slow changes compared to previous tests. They intend to repeat the visual field test in four months time.

Can anyone tell me what more might be done if my visual field continues to deteriorate? If my eye pressure is stable then I don’t fully understand.

[NewCardinal]

It is disappointing isn't it when the surgery we have is so limited in its outcome? Disappointingly, keeping pressure low has limitations in that it is the only thing doctors can do as they don't know what the cause of glaucoma is and, in effect, are only treating symptoms. Loss of visual field, even after trabeculectomy, isn't uncommon. It is happening to me as well. I've had trabs in both eyes but the left eye is continuing to lose vision, the right one a little more stable. Unfortunately glaucoma is a progressive condition for most of us and currently all doctors can do is try and stabilise it by keeping pressure on the central optic nerve as low as possible. Sorry to be so pessimistic, but at lease you're being monitored, as am I. Try to stay positive and follow your doctor's 'instructions'.

[PBX142]

Hi, not sure how helpful this is but anyways...I was told that defects/deterioration in optic nerve can often show up months later in visual field defects, ie the VF result reflects what has been going on with the optic nerve, sometimes some time ago. Also I'm sure you have been told that VF results are variable and you can only get a true picture from comparing not just with the last one but with the previous VFs too. You may find that your next VF shows a better result as mine did last week....All part of the thriller diller ride that is glaucoma!!

[YoungontheOutside in reply to PBX142]

Thank you - that’s encouraging 🥲

[Rastrillus]

I wouldn't worry very much about VF tests, they're very stresful and all of us have better or worse days at doing them.As soon as OCT isn't showing any progression I think is that you just had a bad day.