History Case 1
- born 1935, male,
caucasian, myopic
- 1983, no symptoms,
optometrist suspected glaucoma and referred
- pressure 22
(R) , 23 (L)
- myopic discs
0.6 c/d (R) , 0.7 (L), virtually normal field both eyes
(c/d= cup to disc ratio, explained in photos on this page, normal
is 0.3)
- open angle
on gonioscopy
- diagnosed as
early chronic POAG (primary open angle glaucoma)
- prescribed
g Timolol 0.5% bd (R) & (L)
- achieved pressure
16
- 2002
- by this time
on near maximum topical therapy
- g timolol 0.25%
LA od, g xalatan nocte, g trusopt bd (R) & (L)
- target pressure
12-14
- fields and
discs below (click photo for larger version to show your patient)
- pressure 13
(R) , 14 (L)
- glaucoma considered
stable (fields are not changing)
- healthy lifestyle
and low blood pressure & diet includes
- 5 portions
of vegetables and fruit day
- minimal
animal fat, low in other fats
- 60 minutes
walking/gardening a day, not smoking
- all these
will have direct or indirect effects on the optice nerve, for
instance exercise lowers eye pressure, smoking triples risk
of retinal vein occlusion (estimate)
- future: little
change (at such low pressures within target range)
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