Difficult diagnosis

[SligoPort]

I am finding the wait and wondering stressful. I was referred in July and still not given a diagnosis. Due to normal pressures I had to have an MRI of brain and eye orbits. The result showed relative optic nerve thinning of the right eye and a hyperintense signal in the vision region of the brain. Consequently I was asked several weeks later to have the scans again with contrast. I’m still waiting after over two weeks to hear. As the results weren’t back at my appointment last week my Dr decided to do a neurologist referral as he’s not convinced it’s glaucoma. I have normal pressures with peripheral nasal vision loss just in the right eye. He thinks I would have signs in the left eye due to the thinning progression in the right. I have been using Monopost that hasn’t lowered the pressures from 19 and 18 so now starting on a combined drop. Is it exceptionally unusual to take a long time over a diagnosis and can glaucoma damage just be in one eye? I’m terribly nervous of anything else this could be as I haven’t heard of others going to a neurologist. I have normal pressures, no other health symptoms other than lack of sleep due to worry and how long this is taking. I’m still classed as a glaucoma suspect with Inferior notching of R disc and Nasal step field defect. Sorry for long message.

[KieranGlaucomaUK Administrator]

Hi. Sorry to hear that you are still awaiting a diagnosis, I'm not surprised that you are stressed. Glaucoma can be hard to diagnose, and sometimes can take a while, especially when eye pressure is within normal limits. Normal tension glaucoma is quite common and we speak to quite a lot of people with it. You can also have glaucoma in one eye. I hope you get some further answers soon and hopefully the new eye drops help a bit more than the monopost alone.

[SligoPort in reply to KieranGlaucomaUK]

Thank you for your kind words. Hopefully I’ll get some answers soon.

[balacakkhu]

Hello, The neurological cause of visual field vison is Pituitary tumour. In normal pressure glaucoma cases this should always be excluded by brain scan. To maintain the IOP is very delicate job. I have normal pressure glaucoma with lost my nasal field on my left eye. I needed various drops on both eyes to make sure the pressure is not going up for many years. At the end the consultant decided to do trabeculectomy and now i do not need any drop.

[SligoPort in reply to balacakkhu]

Thank you for this information. I’m glad you’re now in a situation without requiring the drops.

[balacakkhu in reply to SligoPort]

There are a few other things you may want to know - some of the other possible causes like blood circulation and blood pressure, lack of vitamin B12 etc may affect on the optic nerve. I was investigated for 24 hour BP monitor, 24 hour IOP check, B12 level checked etc. The problem of normal pressure glaucoma is what is normal? it all depends on the individual variation. To keep the pressure as low as possible along with monitoring the visual field. Please also look after your self including healthy balance diet. You will be fine with the careful monitor by the consultant. with best wishes.

[Sodalover]

I have more or less the same as you, currently waiting for an MRI with contrast. I lost upper half vision in my right eye in March, first consultant just said it’s glaucoma and prescribed mono post eye drops for just my right eye. Second consultant is suspicious of the cause hence the second MRI. Pressure in both eyes is 17. I paid for a private consultation where they agreed not typical of glaucoma, there are swollen blood vessels, damage to optic nerve in right eye but left eye is fine. Latest thinking is that I’ve had a stroke, I’m very nervous but can’t do anything until I’ve got results.

[SligoPort in reply to Sodalover]

Thank you for your reply as it definitely sounds like we are in a similar situation. I’m finding the anxiety waiting to find out any news very difficult as it’s easy to imagine all the worst things. Sending you lots of positive vibes for some reassuring results. I believe a neurologist will look at my results and then continue with any more tests required to give the answers. It all seems to take so long and it would be nice to be able to sleep again at night. Take care and hopefully we can compare results in the near future.