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Hi l am 47 and been diagnosed glaucoma for ten years,l dont think l have lost any vision as my peripheral and central vision tests are still good l have been taking eye drops for ten years but my eye specialist said they are no longer effective as the nerve damage in my eyes has been getting worse over past ten years.. He said the higher the number the worse it is and in the past ten years l have gone from a 2 to a 4. l am not sure what he means by going from 2 to 4 can you explain what that means ,how bad is a 4.  l am in AUstralia so it might be a different system.
l had SLT laser yesterday , my eye was red for  day and it cleared up, l will see him in 4 weeks and he will tell me if its been succesful in lowering the pressure .He said he wants to get me from 20 to 15 pressure  IF SLT does'nt work what do you think my best other options would be is there another type of laser , l dont really want surgery l prefer laser
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233488 tn?1310693103
1. what drops were you taking before your laser surgery (SLT=selective laser trabeculectomy)?
2.  I suspect, but cannot tell you for certain, that your Eye MD ophthalmologist was talking about the cup/disk ratio     and probably  means .2 to .4.   the C/D ratio is notoriously inaccurate in assessing. So there must have been some objective damage that your glaucoma was progressing such as worsening of visual field test or thinning of the nerve fiber layer (NFL) on OCT test.   You can confirm this with your Eye MD if you wish.
3. The SLT is really the only common laser used for mild/moderate glaucoma treatment (ALT is older method, it is 'hot' laser).
4. If SLT now lower IOP enough then there are several new glaucoma medications (here in USA named Vyzulta and Rhopressa) that could be tried.
5. Because you have glaucoma at a young age all your blood relatives are at higher than normal risk and should know to see Eye MD ophthalmologist yearly and tell him/her about your glaucoma.
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thanks yes upon your earlier advice l told my sister to get checked and she was normal . l was taking azarga and xalatan but they only got my pressure down to 18 and 20 and he said l need to get to 15 because the nerves are getting worse so l need SLT,  l dont think  Vyzulta and Rhopressa are avialable here in AUstralia.
if l have a C/D ratio of .4 l think .4 still means early moderate glacuoma? is that correct. l was worried when he said l have gone from a 2 to 4 he might have meant from stage 2 to stage 4 glaucoma which is serve glaucoma , but l dont think he meant that  as l still have good vision 20/20 and l think l passed my recent peripheral flashing light test and l have'nt noticed any change to my vision over the past ten years apart from more eye floaters
At this point you need to direct the questions to your ophthalmologist
You will need to ask your ophthalmologist what she/he means.  There is a much stronger medicine than xalatan that just went generic  called travaprost,
thanks l see him again in a few weeks, l had the SLT five days ago , l still got a slight aching pain in my eye,  is that normal
Typically we use a steroid drop for about 5 days to prevent that symptom.  You need to ask your surgeon about that symptom.
thanks , he did'nt give me a steroid drop or any drop to take,  , also he did'nt measure my pressure afterwards, l thought he was supposed to do that to check for a pressure spike. But l see him again in 2 weeks .
Something you will need to discuss. We use special eye drops to keep pressure down at time of SLT (in US iopidine) however we don't check IOP at 30-45 minutes the way we used to because these drops are so effective. In ultra-severe glaucoma with a lot of damage we will check IOP in 30 minutes post SLT
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