Hi. Any help, advice or support would be appreciated please. I had a trabeculectomy in January and had needling done 13 days ago. My pressure dropped to 1 and I was prescribed Atropine drops. It rose to 2 a few days later but not much improvement. A few days ago, the steroid drops were reduced and gel was injected to widen my anterior chamber as it was shallow. To date, I am not sure if it was successful as my vision is still distorted in the eye. I have been told that the Atropine will cause blurry vision but it seems more distorted on the side of my eye. Has anyone had such an experience with the treatment of low pressure and how long before it settles at a good reading? My eye watered a lot after the gel injection so I wondered if it leaked out. Any shared experiences would be welcome.
Low eye pressure following needling. - Glaucoma UK
Low eye pressure following needling.
I think everybody’s recovery is different. I had my surgery in September and in the first six weeks I had to have it needled twice plus the three releasable stitches taken out as it was healing too fast. I have had four weekly post checkups + two weekly checkups for six weeks and now on monthly my pressures have stabilised at seven for the last four weeks. I’m hoping this stays the same as it did go down to 4 at one stage your recovery will be different to everybody recovery because everybody’s body is different. Just take it as it is take every day as it comes and every post check up as it comes all the best for Christmas and I hope you get some good news and feel better.
Commiserations Mitziecat . I had a second trab in September following a failed operation 12 months earlier where the trab had disappeared completely leaving just a hole in the eye. Both immediately before and immediately after this second operation my pressure was zero which caused a lot of concern. A week after the second op I had a gel injection and it went up to 9 after which it fell back to 4 where it has remained
I was prescribed 1% Atropine for 6 weeks post the second op . 1% atropine is very powerful and as I understand it amongst other things paralyzes the small muscles that control the movement of the eye. My vision was very distorted and blurry even for some weeks after I came off the atropine as it worked its way out of my system which I believe is quite normal .
My vision is now coming back slowly . Having used a particular technique my consultant has explained that it is far better that the pressure stays low at this stage , that his principal concern is still that it rises too quickly and overshoots , and that the best long-term results are obtained if the recovery of vision is slow and gradual .
Thank you Pjhl. It is reassuring to know that it will eventually settle. I would be happy if my pressure settles around 9 as it has previously increased too much. I will probably have a few more weeks on Atropine but happy if it increases the anterior chamber and helps to stabilise the pressure. Enjoy the festive period and wishing you the best with the eye health.
Hello, Atropine eye drops do cause blurred vision. Blurring of vision after needling, will be variable in severity and can last for several weeks. Please do also speak to your eye clinic about any concerns you have. Wishing you all the best.
Thank you for the information and I will ask questions at my review. Have a lovely festive period and thanks for the support you give.
Hello Mitziecat,
I had pressures as low as 4 following a different procedure (Preserflo) with distortions at the top left edge of my vision (between about 8 O'clock and 11 O'clock). If I moved a pencil across my vision it distorted wildly at this edge. This was caused by a Choroidal Effusion, which is when fluids get between the layers of the eye causing the retina to be distorted. If this sounds like what you have you should make your surgeon aware if they aren't already.
In my case I was on Atropine on and off for about 7 weeks while they hoped my pressures would rise. They were about to operate again to fix the problem when the eye finally showed some improvement on its own, so instead they did the gel injection procedure (that you have also had) which pushed the eye back into shape and the choroidal vanished. Atropine was stopped, but when its effects wore off the choroidal thought about returning, but only briefly - the pressures were rising by then and it finally went away for good.
I think I was told that my eye would water a bit after the gel injection, but I can't be certain now.
Some eyes can tolerate low pressures better than others. Mine needed about 7 to force the choroidal away. Yours may still be too low.
I think Atropine forces the eye to focus at distance, so, as I'm long-sighted, blurriness wasn't a problem for me, but if you aren't then you will have to live with blurriness until you come off Atropine (or get a temporary pair of glasses with a new prescription - probably not worth it). It takes about 3 weeks for the effect of Atropine to wear off completely once it is stopped.
I suspect you will be okay once your pressures are up a bit more and the Atropine is stopped, but keep your surgeon informed and follow their guidance.
Thank you for your response and advice KayGeeBee. It does sound as though It could be choroidal effusion. I passed my finger across my eye and it did become distorted at the upper right area of my eye. I heard my consultant mention choroidal at my last review but he did not say if there was a problem with it. I will mention it next week at my review.
I think that I will have to be patient and give the Atropine time to work. It is frustrating as I only got new glasses 3 months ago. Hopefully the prescription will be good after my eye returns to normal. I am currently using steroid drops and they were quickly reduced to encourage some healing, in the hope that it would raise the eye pressure. Hopefully the combination of treatment will give a good outcome.
All the best to you and have a lovely festive period.
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