Acute Closed Angle Glaucoma

[Wildeverose]

Hi allLast September I had an acute closed angle glaucoma attack in left eye. The consultant did iridotomies in both eyes and the pressure in left eye reduced with lots of various drops to in the teens at the time. The drops were then stopped. Recently I saw the consultant who said pressure left eye had crept up to 26 and I need to start Tiomolol drops to stop it going any higher. He also said it was impossible to get the pressure down as the angle was closed in the left eye. Has anyone else been told the pressure would not come down due to the closed angle?

[KieranGlaucomaUK Administrator]

Hi there. Usually if the iridotomy does not work or the effects wear off, then they sometimes arrange for a clear lens replacement surgery (cataract surgery) to be done. Replacement of the lens can allow the iris, which is bowing forward, to fall back and re-open the drainage angle. You haven't mentioned if you have had cataract surgery in the past. If you have, then it's not something that they can repeat. Drops can still help the pressure though, so it's good to hear that he had prescribed some for you.

[Wildeverose in reply to KieranGlaucomaUK]

Hi, Thank you for replying. No I haven't had cataract surgery at all. The consultant has mentioned it but apparently it's risky. When I had the glaucoma attack the lense became stuck to I think iris and my pupil has been dilated ever since.

[Belladoodle in reply to Wildeverose]

Hi there,

Do you have any symptoms from one pupil being dilated. I had a closed angle incident last year and the pupil got damaged. I am finding my brain is struggling to deal with the different levels of light coming in the 2 eyes. I had cataract surgery on the other eye as a preventative measure to stop another close angle incident. Good luck with the drops.

[Wildeverose in reply to Belladoodle]

Thank you. I know what you mean about the light. I do have transition lenses in my distance glasses though, I've had them for many year's, long before the glaucoma attack. The eye I had the attack in has always been a lazy eye, probably a weak eye too, so transition lenses have always helped with strong sun but helping more now with having the dilated pupil.

[Seahorse0 in reply to Wildeverose]

HiI'm sorry to hear of your eye problem.

I had iridotomy in both eyes due to closed angles. As far as I know all now OK (except for a 'line' in my vision right eye - side affects apparently!) although my yearly consultant appointment has been cancelled recently. Sorry I can't help with your query, however may I ask you a question please?

You mentioned Transition glasses, I suffer awfully with glare & lights. I'm wondering if you know if the transition glasses can be worn in the dark winter morning/nights whilst driving? I am struggling to find a decent pair of glasses to help with this

Kind regards & best wishes

[Wildeverose in reply to Seahorse0]

Hi there, the answer to your question about transition lenses is, I wear them all the time regardless of weather, driving etc. They're in my distance glasses not the reading glasses. I have recently got a new pair, they're the best I've ever had. I got them from an independent optician. Well worth the extra cost. Hope this helps.

[Seahorse0 in reply to Wildeverose]

thank you so much for the quick reply , that is most reassuring . I would be putting in my distance prescription also

[Efabear]

Hello. I have angle closure glaucoma. Lens replacement is the recommended treatment. I've had it done in both eyes plus they also ppened the angle in one ( gsk). My Consultant describes it as the eye@s being crowded so removing the lens and replacing it with a thinner one creates space and by doing so opens the angle and the pressure drops. I was reticent about my good eye being done as there are risks but it has made a massive difference. From uncontrolled high pressure my pressure is now normal and I'm o ly on one drop in one eye rather than x 4. Hope this helps

[Wildeverose in reply to Efabear]

Hi, thank you for explaining, it's very reassuring. If the drops don't work and the pressure keeps rising and I get offered the chance of a new lense. I'm sure I'll take it although it's risky. Pleased that having the new lenses has made a massive difference to your eye pressures.

[Pley]

I have had closed angle glaucoma in both eyes for the last ten years. I have had both the laser treatment and lens replacement in both eyes. I'm still having to take drops every day. But my pressures are reasonably stable at 17. Down from over 30. But I know that this can quickly change.

[Wildeverose]

Pleased that your pressures are now stable. Let's hope they stay that way and no changes at all. Thank you for replying to my post.

[SpanishFlea]

We seem very similar. I too have a lazy left (to the extent that I only use the right eye for all practical purposes. The acute angle closure I suffered in December was in the left eye, and it destroyed 40% of the optic nerve. The right eye shows no sign of glaucoma or cataract and is very healthy. Iridiotomies in both eyes had no effect on on the left eye pressure so I had cataract surgery (had never realised I had a cataract) on left eye, where the channel was completely blocked. Pressure dropped to 12 and has mercifully stayed there (using Trusopt and Monopost) but the channel is still very narrow as I have small eyes. The channel is similarly naturally narrow in the right eye but they aren't risking surgery as the left eye problems in no way affect my right eye vision. The only issue is with bright light as my left eye pupil is totally frozen. I have an excellent pair of clip-on sunglasses and make sure I have them available at all times. If they offer you cataract surgery, I hope it is similarly successful. We lazy eye closed angle sufferers are a rare breed!!

[Wildeverose in reply to SpanishFlea]

I really can't believe that the similarities with our eye problems are practically the same, same left eye etc. Thank you for telling me your experience. I am so grateful for what you have told me. I am happy that I have joined this group. I hope in the future, your eyes become as problem free as possible.

[ChristinaGL in reply to SpanishFlea]

I have closed angle in my left eye and narrow in my right with higher pressures in my left eye - similar to both of you! And have had the laser iridotomy. This is all since March. The consultant suspects I have plateau iris as the iris did not bounce back after the laser iridotomies. He also mentioned cataract surgery as an option though I don't have cataracts, and I am wondering if you had this just in the left eye or in both? And what might be the effects on vision of just having the new fixed lens in one eye? I am quite long-sighted needing glasses for close-up. Thanks

[SpanishFlea in reply to ChristinaGL]

I just had the lens replacement in my left eye. Because of my lazy left eye and the absence of any sign of glaucoma in my right, it was deemed best just to do one eye. If you don't have a lazy eye, lens replacement in both will give you well balanced eyes apparently., whereas only having it in one eye risks leaving you with double vision. The cataract surgery tends to reduce long-sightedness, I understand, but the vision in my glaucoma eye is so poor that I can't confirm or otherwise. Discussing with your consultant would seem the best way forward. Good luck!

[ChristinaGL in reply to SpanishFlea]

thank you SpanishFlea, that is very helpful. No-one has explained that to me before.

[Wildeverose in reply to ChristinaGL]

Hi, the closed angle attack was just in my left eye but they did the iridotomies in both eyes. My right eye is ok. I haven't had any cataract surgery in either eyes. The pressure in my left eye has crept up to 26. They have put me on Timolol eye drops twice a day, hopefully so the pressure won't rise any more. My pupil is permanently dilated too!!!

[ChristinaGL]

I do hope that you find stability for your left eye. I have a similar situation and am wondering about the cataract op root which the others have mentioned. Good luck!