Can you help with why I continue to have pain In my right eye?

[Harperj123]

I have recently been diagnosed with early signs of open angle glaucoma here this past March.  My doctor has been treating me for high eye pressure for a little over 2 years. They were stable until this past January.  I’ve had reactions to many of the drops. Right now I’m on rocklatan and generic cosopt. My pressures are finally stable with IOP of 13 and 12. I’ve also had lasik so that would put me at 17 and 17. I continue to have discomfort/ redness in my right eye randomly only during the day. At night I experience dryness in the right eye as well and have to apply gel drops. Also I sometimes get several black flickers or dots in my right. I’ve told my doctor and he doesn’t have an answer. Any insight would be helpful?

[John C Hagan III, MD, FACS, FAAO]

The first thing I would suggest is that you see a glaucoma specialist, not a general ophthalmologist.  I would suggest you discuss SLT or selective laser trabeculoplasty to try and get you of some of your eye drops.  At present the recommendation is to try SLT first before using eye drops.   Both of your drops can cause eye pain, redness, irritation and discomfort.  The dots may be floaters and are a different problem.   Get a second opinion about SLT.

[Harperj123]

Thank you doctor.  I did get a second opinion about a month ago before and SLT or getting on rocklatan was recommended. When I saw my current doctor whose been treating me the past two years and who performed my LASIK  was leaning more  towards medication than SLT. So I’ve been on rockatan for a little over a month.  I’m only 42 years old and trying to get us much information as I can moving forward. Thank you for your help.

[John C Hagan III, MD, FACS, FAAO]

So you have got a second opinion that SLT is recommended and I have said that SLT is now the first choice for treatment of open angle glaucoma. Strongly consider seeing a glaucoma specialist and getting a SLT.

[Harperj123]

Update… I just saw a glaucoma specialist and based on his oct, visual field test and him stating that my optic nerves look healthy is stating I don’t have glaucoma but I have ocular hypertension. Waiting on records from other doctors who he knew of and stated both are not glaucoma specialist. So he told me to stop taking all the drops so he could see where my pressure are at it’s highest off meds.  His baseline for me is for my iop’s to be in the mid 20s or less.  He was referring to a study that some can have high pressures and not develop glaucoma.  So what are your thoughts on that? Also he is aware of my thin corneas from LASIK procedure.

[John C Hagan III, MD, FACS, FAAO]

I would go with the glaucoma specialist.  

[Harperj123]

My readings in both my eyes today were 30 and he didn’t seem that alarmed as my other doctor would have been. So he prescribed me  timoptic ocudose .50 a preservative free drop 50 to take  in the morning only.  Just a little concern, as I see  on this forum concerns about pressures that are in low 20s or high teens.  But yes  I am going with the glaucoma specialists.

[John C Hagan III, MD, FACS, FAAO]

You didn't say your IOP was 30 and that he started treatment.   There is a study done that shows that treating IOP that high early before damage occurs to the eye is better than waiting till damage occurs. I don't have much more to say. I would stay with the glaucoma specialist.