First I must apologise, I am new to Glaucoma and looking to get some guidance from ideally someone who may have had a similar experience.
I am a 44 year old male who was diagnosed with narrow angles following a routine eye exam. My eyesight is pretty good and I only wear reading glasses occasionally, apart from one instance of a slight halo I had not had any symptoms so this came as a surprise.
I was referred for laser iriditomy in April and had this on the Friday. On the Sunday I was in so much pain that I went to the eye clinic and the pressure was 70 so I had to have various drops and drugs to reduce this and was referred to have additional cataract surgery which is happening this Friday.
They explained that the laser treatment was not a cause of the pressure increase and I was a ticking time bomb. Fortunately I did not have any noticeable damage as a result of the event.
My concern is that at 44 I’m having surgery based on one event and this will likely worsen my eyesight in the short term. I feel like I’m coming across as a crazy conspiracy theorist when asking questions to the surgeon and he hasn’t really detailed the additional steps that they are planning as part of the surgery.
Any advice would be greatly received!
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Martyn321
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Did you notice much change in your vision as a result of the lens? I’m also being told I’m having this done under a general so was wondering if you could help me understand how you found the recovery period?
My situation was a little bit more complicated - this was 2011 and I don`t think at the time that they routinely did lens replacement for narrow angles.
As I said before I had iridotomies in1994 and all my check ups at the Glaucoma Clinic in the years following have been fine. Then in 2011 I developed a macular hole ( tear in the retina) in my right eye and the surgeon said that while he was repairing that he would do the cataract on that eye which would give me a bigger drainage channel.
I chose to have a local anaesthetic - the lens replacement doesn`t take long and the recovery even in my case was pretty straightforward - mainly using various drops for about a month as I remember. This was thirteen years ago so any advice they give you now may be different to then.
With the care and treatment I`ve had in the last thirty years I feel lucky that I have never had an acute attack, still have good vision for my age and so far no sign of any damage to the optic nerve. Just daily drops.
This is all about prevention and well worth it. Just like me you have been given the chance to have the treatment before anything goes seriously wrong.
I have closed angle glaucoma in both eyes and have had both the laser treatment and then cataract surgery in both eyes. The surgery is painless and has helped reduce my pressures. But I still have to take eye drops.My best advice is take the advice about your recovery after the surgery. Make sure you rest and don't try and do too much, too soon. If I remember this could be at least a month.
I had the bizarre feeling of being frustrated about not being able to do anything (like DIY) but didn't feel ill.
Thanks for your reply, I will let you know how I get on after the operation.
Hope you don’t mind the follow up question, I need to have this done in both eyes so will have a follow up op in a month or so, I’m worried about noticeable changes in my vision, did you have any changes after the surgery?
Things got better for me as the new plastic lenses they put in are better than the two natural ones that were taken out. I still wear varifocal glasses as I do need them for reading and they still give a slight improvement on my long distance. But now I could pass the DVLA read the number plate test for driving without glasses, which I could not do before.
I can't give any advice about the surgery, as I was advised not to have it done, as I have another eye disease also. I feel that I'm slowly losing my sight. I have difficulty reading among other things. Best wishes.🐈
I have my eyes tested every year. About 12 years ago I was told I had a cataract growing, then I was told I hadn't , it was like this until last year. I always pay the extra to have the special eye map test. I was then told both eyes have cataracts,and they needed removing. So I went for the pre op, went in one room had some tests, into another with a few extra tests then saw the consultant, who said I had pseudo exfoliation syndrome. He said it would be risky because if I coughed or moved I could lose my eye. I was willing to take the risk but none of my family were. So I said no. I'm only upset because I pay them to look after my eyes and why wasn't any of this picked up before at the opticians. Is it through incompetence or people not properly trained. I have problems reading and watching the tv. I'm sorry I wasn't much help to you before. Life is blurry. Take best care.
hi Martyn, I had cataract surgery yesterday due to dangerously narrow angles which were discovered by the optometrist during my last routine eye exam. The op was much easier than I could ever had imagined, and with regard to your query to one of the earlier replies, I was reassured to discover that my sight with my regular varifocal glasses is perfectly manageable for both distance and reading. I've been scheduled for the second eye op on June 12th, which means a reduced time to have to abstain from some of the exercise I partake in.
Like you the narrow angle diagnosis came as a bolt from the blue and after researching it I had decided in advance Cataract surgery was probably the best option long term, so hoped to avoid iridotomy.
A fellow patient at the hospital was around your age and had a very similar story to tell, he had also felt relief for the option of cataract surgery.
Good luck for Friday, I'm sure you won't regret it.
Thank you for taking the time to reply to me. I will certainly update everyone and hopefully this will also help those that are unsure of the treatment.
I had been on Latanoprost for about 2 years (originally for OAG, later changed to narrow angles) when the pressures crept up from 18 to 21. The consultant added Brimonidine and within 3 months one eye had gone up to 27. andthe other down to 17.
I was sent for iridotomy in both eyes the following week. After half an hour I was vomiting, and when the pressures were checked after an hour they were over 60. The doctor who did the operation said she had never had this happen before. I spent the next 6 hours having drops, tablets and glycerol (which of course came back up!). Eventually some IV drug was used (not specified on the GP's letter) and my eyeball prodded because it "was stuck". I was sent home with pressures in the 30s. The explanation given was (a) it was due to trapped pigment (I have blue eyes) or (b) inflammation, which will be an ongoing problem if I have any other surgery.
After steroids, tablets and extra drops I returned to the original regime of Latanaprost and Brimonidine and after 3 weeks the right eye was again 27 and the left had increased to 21! Forunately I saw a different doctor (not the consultant) who said I shouldn't be on Brimonidine long term and should also be on preservative-free. She changed to Ganfort and the right eye went down to 18 within a few weeks.
Was the iridotomy necessary? Not sure
Did it cause the pressure spike? Yes, though mine was immediate.
I keep being warned that I will need cataract surgery eventually due to the narrow angles and I am terrified that it will blind me. At least I am forewarned now.
I will let you know how I get on, however your story sounds very similar to my own. They assured me it could not be a result of the laser iridotomy but I can’t see how this cannot be linked.
I’m also very anxious about the obvious worse case scenarios but would not want to experience another acute event again which I have been advised is almost inevitable with time.
Everything for me is happening very quickly as I was only diagnosed around March this year.
Your reaction was maybe less severe than mine as it seemed to take longer to build up. The ironic thing is that the whole point of iridotomy is to prevent this happening. I would definitely make a point of mentioning it again when you go for cataract surgery. One doctor vaguely suggested that they can give extra steroids, and another that they may put in a shunt at the same time.
I have found that ophthamologists tend to contradict each other - on one video (I think it was on Glaucoma UK, but not sure) the doctor actually admitted this!
I understand your surgery is today so you may not see this, but I send my best wishes anyway.
Hello Martyn, I have just been reading all the previous posts and note that today is your Op. My thoughts are with you and I hope everything goes well and according to plan. Our eyes are so precious and the thought of eye operations can be very scary! I had cataract surgery on both eyes 14 years ago and had a Paul tube implant fitted in my right eye almost four weeks ago, so am recovering slowly but my consultant surgeon seems pleased. When you are up to it, I am sure you will be writing to keep us all updated. We are all thinking about you and wishing you well. Gill xx
Thanks Gill for the reply, I am really blown away but how knowledgeable and sharing everyone has been.
I had the op today, the doctor was great and basically explained that anatomically my eyes are just so crammed that they needed to make space, the lens and laser was in their professional opinion a must do or I would risk a lot worse.
Back home now with the meds and a bit of sore eye but nothing unmanageable, will see how the vision settles in a few days but I feel I am hopefully over the worse and felt in very safe hands.
I was in my local Queen Victoria Hospital in East Grinstead so was very lucky to have a specialist eye clinic close to me.
Thank you to all that have provided replies, time to heal up and then get the right one done in a couple of months.
Hi Martyn, Wishing you all the very best for a speedy recovery from today’s op. Take care of yourself, do not try to do too much in these very early days and take things slowly. Please try to keep us informed of how you are progressing. Kind regards, Gill x
Hi Martyn, Thanks for letting me know how you are progressing. It can be such a worrying time. I hope your check-up today (Monday) goes well. It was five weeks yesterday since my surgery (Paul tube implant). I am due to see the consultant on 13 June, after having to visit him every week, so quite a relief. I just hope he says everything is fine. Take care.
Hello Martin, Sorry for not replying sooner but I went on a short trip to the Lake District and am still trying to work out what day it is - or even what month it is! The weeks seem to go by so quickly. My check-up on 13 June went ok apart from the pressure in my operated eye being rather high, which was disappointing. He put some drops in and asked me to wait for half an hour, then checked the pressure again. It had gone down slightly, but now I am having to use Brimonidine in the operated eye along with all the other stuff! Every day I make list then tick them off, otherwise I would lose track! I have different drops for my unoperated eye, so it’s all a bit of a performance. You will know this yourself if you are on six different drops a day!
I was due to see the consultant again today, but my driver was poorly this morning and it was too late to find another at such short notice, so I have had to postpone my appointment until next Thursday. I hope my eye will not suffer. I’m pleased to hear the doctors are pleased with you and that you seem to be going on ok. It’s a slow job, isn’t it?
Hope you’ve been enjoying the good weather - and that it didn’t dry out your eyes too much? I’ve been trying to remember to use my Thealoz drops in between all the others! While I was away recently, my eye drops regime got all out of sync, but luckily I managed to get them all done each day!
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NHS decision sheet on open angle glaucoma (high eye pressure)
SLT laser surgery procedure 
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I don’t want to go on
narrow angles
