Glaucoma Eye Drops: Managing Light Sensitivity and Discomfort - Ophthalmology

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Glaucoma eye drops and light perception?


A week ago, my intraocular pressure was measured at 26 and 29 at the ophthalmology clinic.
The doctor prescribed glaucoma eye drops (Xalatan), which I have been using twice daily for a few days.
After starting the drops, my eyes have felt very fatigued, and I noticed glare in both eyes.
When looking at lights, they appear to radiate multiple lines, especially in darker environments, without any rainbow effect; the color of the light is the same as the lines (I never experienced this before using the drops).

Four days later, during a follow-up appointment, the doctor mentioned that the glare was caused by corneal abrasion, explaining that sometimes glaucoma eye drops can cause this issue.
He prescribed a fatigue-relieving eye drop (Tears Naturale) and an eye ointment, and advised me to continue using the glaucoma drops since the glare had not improved.

At another clinic, they confirmed that my corneal abrasion had healed but diagnosed me with allergic conjunctivitis and prescribed new eye drops.
I have stopped the glaucoma medication for now, but the issue with light perception persists.
I would like to know if this could be related to allergic conjunctivitis, as the symptoms began after starting the glaucoma drops.
I am unsure if there could be other causes or if it could be due to a change in astigmatism.
The doctors at the clinic were unable to provide answers.

Huang, 20~29 year old female. Ask Date: 2017/11/23

Dr. Cai Wenyuan reply Ophthalmology


Hello: Your description is uncommon, and it is recommended that you visit a medical center for examination.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/11/23

More Info


Your experience with light sensitivity and discomfort after starting glaucoma eye drops is not uncommon, and it can be attributed to several factors, including the effects of the medication, underlying conditions, and potential changes in your eye's surface.

First, let's discuss the glaucoma medication you were prescribed, which is likely a prostaglandin analog or a beta-blocker. These medications can sometimes cause side effects, including ocular surface irritation, which may lead to symptoms such as dryness, discomfort, and light sensitivity. The fact that you are experiencing glare and seeing rays of light emanating from sources could indicate that your corneal surface is reacting to the medication. This is particularly relevant if your doctor mentioned that the drops could cause "corneal abrasions" or "breaks" in the surface of your eye, which can lead to increased light sensitivity and discomfort.

Additionally, you mentioned that you were diagnosed with allergic conjunctivitis. This condition can exacerbate symptoms of light sensitivity and discomfort. Allergic reactions can cause inflammation and irritation of the conjunctiva, leading to increased sensitivity to light and visual disturbances. The combination of the glaucoma drops and allergic conjunctivitis could be contributing to your symptoms, as both conditions can affect the ocular surface and overall comfort.

It's also worth considering the possibility of changes in your refractive error, such as astigmatism, which can occur due to corneal changes from the medication or from the allergic response. If your cornea is not smooth or is irregularly shaped, it can cause light to scatter, leading to glare and halos around lights. This is something that should be evaluated by your eye care provider, especially if you have noticed a significant change in your vision.

To manage your symptoms, it is crucial to follow your eye doctor's recommendations. Since your eye pressure is a concern, it is important to continue using the glaucoma drops as prescribed, unless advised otherwise by your doctor. However, you should also communicate any persistent discomfort or visual disturbances to your healthcare provider. They may consider adjusting your treatment plan, which could include switching to a different glaucoma medication that may be less irritating or providing additional treatments for your allergic conjunctivitis.

In the meantime, using preservative-free artificial tears can help alleviate dryness and irritation. These can be used frequently throughout the day to keep your eyes lubricated and comfortable. If you are experiencing significant discomfort, your doctor may also prescribe anti-inflammatory drops or other medications to help manage the allergic conjunctivitis.

In summary, your symptoms of light sensitivity and discomfort after starting glaucoma drops could be related to a combination of medication side effects, allergic conjunctivitis, and potential changes in your corneal surface. It is essential to maintain open communication with your eye care provider to ensure that your glaucoma is managed effectively while addressing any discomfort you are experiencing. Regular follow-up appointments will help monitor your eye pressure and overall eye health, allowing for timely adjustments to your treatment plan as needed.

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