Whose advice should I follow?

[YoungontheOutside]

I had a trabeculectomy 18 months ago. Last July I went to a Moorfields virtual clinic for monitoring. I received a letter from the doctor a few days later to say that my visual field on the operated eye was gradually worsening & that I would be seen at the Consultant led clinic four months later.

I was anxious & so went to see a Consultant at Moorfields Private in September. I had seen This consultant in the past at Moorfields NHS and this is why I chose him.. He said that the pressure in the operated eye was still too high (11) and needed bringing down. He changed my eyedrops to Bitsmaprost. He was happy for me to wait for my NHS Moorfields appointment so that the effect of the new drops could be monitored

At the NHS appointment which came through for last week, I was seen by a specialist ophthalmologist rather than a doctor or consultant. My eye pressure had scarcely changed at all despite changing drops (in fact, it was slightly higher). She told me that my visual fields are not really to do with pressure & thst my last three VF tests were similar enough not to worry about. She said that the problem was really that I had myopic CNV for which I had four injections about four years ago into the Covid period. She said my loss of visual field is where the Fuchs spot is. So she didn’t consider there was anything to be gained by lowering the pressure. In fact, she said I could swap back to Latanoprost because all the Bitamoprost has done is to make my eyes very sore. My instinct is to accept what she has told me.

But I don’t understand why I didn’t get broadly similar advice from each of them. The private Moorefield consultant had full access to my NHS record but didn’t mention the Myopic CNV. I paid nearly £700 for the consultation with him and so am strongly questioning what is the best advice.

[icannotthink]

I have spent a small fortune on PRIVATE CONSULTATIONS and I just seem to be getting nowhere. Just keep persevering and hopefully it will all COME RIGHT eventually. God Bless

[VerdiG]

I had a conflict between NHS and a private consultant. The consultant told me that opinions will vary between specialists. I opted to go with the private consultant, which reduced my anxiety and allowed me to do all the field tests and eye exams in a very non stressful environment. The NHS wanted me to have a trab in my other eye. The consultant said not necessary at this time. I went with my gut feeling and stayed private. Since then my glaucoma has stabilised and I haven’t lost anymore vision. Go with your intuitive feeling. In your case the ophthalmologist sounds more credible. £700 is a lot for a consultation. I only pay £350.

[PBX142]

As your private consultant knew you were going to keep your NHS appt, I would absolutely write to the private consultant and tell him what you were told, and ask him what you should do. I can't see that even if you have non tension glaucoma, when low numbers can still not prevent vision loss, that 11 is too high?! There also seems to be conflicting views about your visual fields....What I find useful is to request copies of them so you can compare yourself. It's useful to know that they can vary so that a subsequent VF test can be better than the last one. PS Presumably the Latanoprost is the preservative free kind, ie Monopost, which is kinder on the eyes. I'm with Moorfields too and have Monopost. It costs more but you're not paying for it - just be sure you get it!!