Disc hemmorage blues

[stephanie1977]

I have had several disc hemmorages on my left optic nerve over the past 3 years. The eye has early glaucoma.After the last disc hemmorage in September 2023 my Dr added another drop and I am on maximum drops. Pressures range between 9-15 . Beginning of June the glaucoma specialist told me my glaucoma had been stable for the past two years. Then I went to my regular ophmatologist and she discovered a disc hemmorage. I assume it is new. So I'm a very worried that although my pressure is under control my glaucoma may not be. Medication remain the maximum of drops.Has anyone struggled with disc hemmorages? And do they always represent progression??? Any enlightenment much appreciated! Thanks

[Sorshup]

The presence of disc haemorrhages is associated with a likelihood of progression. It could be said that they indicate a greater vulnerability to nerve head damage due to even normally safe IOP levels.. The message to take is that there is no direct therapeutic treatment for the bleeds themselves, and the only medical and surgical help continues to be IOP control. And for you to maintain the best of physical, systemic, health, with attention to diet and exercise. The other self-help path is dietary supplements, e.g. ginko biloba but you then enter the realm of the unknown and unproven, and snake oil salesmen !

[stephanie1977 in reply to Sorshup]

Thanks Sorshup. I think I have to do some health tests like 24 hour blood pressure etc to see if there is a vascular component.

[Beecalmed]

Sadly nothing is certain in glaucoma! Every diagnosis is slightly different; every patient experience is different. Previous poster has pretty much summed up what I would say. I would only add that bleeds like this pop up briefly then disappear, so can be easily missed in between checks. If your ophthalmologist has spotted one, that’s a good catch, but make sure it is reported to your consultant.

SLT might be offered, possibly in too if your drops.

[stephanie1977 in reply to Beecalmed]

Thanks Becalmed! Will investigate and discuss more in depth with my Consultant ....see if there is a specific reason as to why I get them!

[Iona57]

Hi Stephanie, I was diagnosed wirh normal tension glaucoma two years ago and have gad several disc haemorrhage. I had hydrus shunt surgery plus cataract in Dec 2022, then put back on drops as pressure not down enough. ⁹I had a couple more bleeds but eye pressure and visual field tests showed eye was more or less stable. However a few months ago I seemed to be losing some more vision near the centre, according to visual fields tests and my perception. I then got another bleed. This swung the decision to go ahead with trabeculectomy, as my consultant said that, together with vis field results, the bleed was indicating there may be further progression. So in my case bleeds have sometimes been associated with signs of progression, and sometimes not!

[stephanie1977 in reply to Iona57]

Thank you lona57! This glaucoma journey is a bit rocky. Thanks for telling me about your disc bleeds. I get the feeling that they follow damage that has occured. Last year I know I didn't have adequate pressure control I was really really struggling with allergies to drops in both eyes plus a failed trabeculetomy in the right eye) and thats when I perceive damage was done although the Ok CTs and visual field tests are ok. It has been 8 months since we added an additional drop and pressure are good now but then suddenly a bleed in the left eye so I am thinking it was from the damage done before the additional drop. I know the experts are unclear of what happens first...the damage or the bleed, but I get the feeling that it's it the damage. Do you think that?

[Iona57 in reply to stephanie1977]

Hi Stephanie, oh dear, I'm sorry to hear that you have been going through the wars with your eyes. My impression is that bleeds and perceptible visual damage don't necessarily occur in the same time frame. I'd assumed that there's a bleed, then loss of vision because of this happens later. But it doesn't seem clear.

[stephanie1977 in reply to Iona57]

Hi! There is so much unknown and so much speculation with glaucoma! From what I have read there doesn't seem to be an agreement as to the sequence of events concerning a disc hemmorage. I am stressed about losing any more vision and am anxious to do something...so I will try to get a new appointment with either my local ophmatologist or the consultant . Thanks!

[Iona57 in reply to stephanie1977]

Sounds like a good plan. Good luck!