I am British but I live in Southern Spain. I am on private healthcare as I am retired but not pension age. So, I have been seeing an Opthalmologist in a private hospital who speaks fairly good English.
I had an eye test in July and had high pressure so saw the Ophthalmologist on the 2nd August. He told me I had glaucoma and prescribed Fixaprost drops. A week later I had further tests, and it was ascertained that I had no optic nerve damage, but I was told I had to use the drops forever.
A fee weeks later I started feeling unwell. I wear a Fitbit and it was registering my heart rate was much lower than normal (it's already quite low, as is my blood pressure) and I was also getting dizzy spells and passed out a few times and I had shortness of breath. I got an appointment to see the Opthalmologist straight away when I told the clinic my symptoms and he immediately took me off the drops which apparently have a beta blocker in. So he prescribed Monoprost.
I have been taking these now for about 6 weeks and although I am not getting the other symptoms, I am still getting dizzy spells and they ate affecting my day to day life.
The ophthalmologist I am seeing only works in our local clinic one day a week and I can't go anywhere else because my insurance will only pay at certain clinics. He told me he wanted to see me in December but I am concerned that maybe I should see him sooner. However, I don't know if I am just wasting my time and his as dizziness is listed as a side effect. Do I really have to put up with this forever?
We have no support groups here and the ones I found on FB seem to be based in the US and things are very different there. Everyone seems to have surgery.
I have read that there are different types but he didn't tell me which. he haant taken my blood pressure or anythubg and I would rather not take this medication if it makes me feel like this.
Does anyone have any advice please?
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Costadelsol
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If you are using drops only once a day you could try using them just before you go to bed, then the dizziness won’t affect you as much, just a thought. I had dizziness with Monoprost but it wore off after I had been using it for a month or so. Everyone is different though…
Based on the information you have provided it sounds like you have ocular hypertension. This is where your eye pressures are elevated (over 21 mmHg), however your vision, visual fields and optic disc are normal. This diagnosis means you do not have glaucoma. However, in order to avoid developing glaucoma, eye drops are generally prescribed to help control your eye pressures. It seems like you are experiencing some side effects from the drops you are taking, this is common and generally a few visits are needed to try and find the best eye drops for you. There are over 2 dozen glaucoma eye drops, so there are other options available. Alternatively, some patients who do not tolerate drops well, can also speak their consultant to discuss possible laser treatment or surgery to help reduce dependency on eye drops. Rest assured, there are other options which may be better suited for you. Hope this helps.
Thank you for your reply. He definitely said I had glaucoma. As I said, he speaks quite good English. Its interesting to know maybe something has been lost in translation 🤔
Dizziness is an uncommon side-effect of using Monoprost, (up to 1% of users). I think you need to exclude other causes of dizziness, of which there are several. How is your general health? Are you taking any other medications and for what condition(s) have they been prescribed? Did you have any medical problems before taking the eyedrops? Would it be possible for you to measure your own blood pressure? I suggest you see a GP, or the Spanish equivalent, assuming that is possible. He/she may perhaps refer you to the relevant specialist if that's appropriate. I hope this is helpful.
Before I started taking drops, I was fine. I ran, did weight training, tennis, hiking and never had any dizziness, or any other health issues. I have always had low blood pressure (generally 110/50 or similar). I did wonder about getting a health check but it just seems so unlikely that this is all a coincidence. I don't take any other medication as I was as fit as a flea.
It's all very frustrating and I appreciate your help.
Could you monitor your blood pressure with your own machine to see if the low blood pressure is making you dizzy. If it drops throughout the day when you are only using drops at night or drops first thing in morning after you first get up. It might be a way to determine if the low pressure makes you dizzy, or are drops affect changes in pressure. I have low pressure and sometimes get dizzy spells.
I don't have a machine, why would I have? Sorry but its not like having a thermometer. I appreciate you taking the time to answer, but logic must say that it's the drops.
I will ask the Opthalmologist when I see him. I was really only asking if I have to put up with these side effects. Amandeep's answer indicates this may be a long road finding the best drops.
Quite a lot of people do have their own BP machines. They're not very expensive and during the pandemic (and after in the UK anyway) it can be tricky to get GP appointments to check this sort of thing.
Dear Costadelsol, Thanks for your answers to my questions. We're assuming that you have open angle glaucoma, the more common form of the disease, (which I have myself), and that you're using the eyedrops as recommended. Have the Monoprost eyedrops reduced your intraocular pressures, (IOPs), despite the unpleasant dizziness? With no other reason for the dizziness, you may have to try another type of glaucoma medication. (Please be aware that Monoprost has other names, eg., Latanoprost and Xalatan - the technical term being prostaglandin analogue}. The decision to change your treatment would be the responsibility of your ophthalmologist. I hope this is helpful.
As well as different eyedrops you could ask your ophthalmologist about laser trabeculoplasty, a procedure which only takes around 15 minutes and with minimal discomfort. Yours, 'Woodthorpe'.
I have naturally lowish blood pressure and heart rate and was prescribed fixaprost in one eye only and this reduced both BP and HR further. I also became dizzy, some chest tightness particularly with strenuous exercise but no passing out. I stopped about 3 weeks ago and my BP and heart rate are better but still low with some dizzyness. I believe it is taking time to get the side effects of fixaprost out of my system. Could it be the same for you maybe? Fixaprost is Latanaprost ( the preservative free version of Monoprost) combined with Timalol the betablocker. In my case and everyone is different, I know it was the Timalol not the Latanaprost causing the side effects as I have used Latanaprost on its own for years without any issue.
I switched to Monoprost 13th September so I have actually been on them longer than I was on Fixaprost and it was a good week.or so before the chest tightness etc got better, and the light headedness/dizziness is better than it was on the Fixaprost. Not once has this Opthalmologist taken my blood pressure/heart rate and I don't know if he should. It seems to me that maybe he should have?
My ophthalmologist has never taken my blood pressure either, but last time I picked up my prescription the pharmacist asked to take my blood pressure. I declined as, like others, I do have a monitor at home. They're not very expensive and if you are someone that has any issues with blood pressure I would highly recommend getting one.
My low blood pressure has never really been an issue. My GP in the UK said it was a good thing. But clearly being too low was an issue. The Opthalmologist said it was the beta blocker in the fixaprost that was the issue but reading the Monoprost side effects they are exactly the same.
I wouldn't expect Opthalmologists to take blood pressure but they shouldn't prescribe betablockers to those with lowish blood pressure. NHS guidelines say that. Mine asked if I had heart problems. I said no but lowish PB and medication can tip it. I had just tried Brinzolomide which gave heart related symptoms and he still prescribed flixaprost. I don't think they have time to think about it, or read notes as they are swamped. I have now worked out that you have to research and work out questions in advance.
I am hoping to have a better chat next time I see the Opthalmologist but it is tricky because his English is not perfect and my Spanish is not good enough to get accross/understand the technicalities of this. I am confused now though because he said I didn't have any optic nerve damage but I have Glaucoma, which seems like a contradiction from what Amandeep has said above.
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