Managing Eye Health: Concerns and Questions After OCT Results

Q: Managing Eye Health: Concerns and Questions After OCT Results

Hello Hanamoto： Since I do not have experience with this type of OCT, it is best to consult the attending physician regarding questions about the instrument examination. <br>Elevated intraocular pressure can lead to optic nerve degeneration, and even with treatment, there may sti

Control status

Dear Director,
I have lost significant vision in my left eye due to an injury over twenty years ago, and I rely entirely on my right eye for vision, which has been monitored for many years.
During an OCT examination in May of last year, the TI area was noted to be yellow, and the physician recommended starting eye drops (Metrolan).
In May of this year, the OCT examination showed that the previously yellow TI area was at 100 (a decrease of 8 from 108), with a new NS value of 67 (a decrease of 5 from 72) and an N value of 44 (a decrease of 6 from 50).
In August of this year, during a follow-up OCT examination, the TI area was at 90 (now red), indicating a downward trend in values.
The physician switched my medication to Suratan.
Before starting medication, my intraocular pressure was around 22-23, and after using Metrolan, it ranged from 18 to 21 (mostly around 20).
After one month of using Suratan, my initial follow-up measurement was 18.

I am feeling frustrated and anxious about these developments, and I apologize for bothering you.
I would like to ask you the following questions:
1.
Is the change in the TI area occurring too rapidly?
2.
Why did the TI area not show significant changes when my intraocular pressure was 23 without medication, but it has worsened after starting treatment?
3.
Does this indicate that my condition has not been well controlled over the past year?
4.
Despite following the prescribed regimen of eye drops, exercising regularly for an hour, and taking lutein and multivitamins, why am I unable to maintain my condition?
5.
Is my intraocular pressure not low enough? I recorded a pressure of 18 while using Metrolan, and now with Suratan, I also measured 18.
Should it be lowered further?
6.
Are there any other concerns I should be aware of?
Thank you very much! I appreciate your help!

hanamoto, 50~59 year old female. Ask Date: 2021/09/12

Dr. Gao Pilin reply Ophthalmology

Hello Hanamoto: Since I do not have experience with this type of OCT, it is best to consult the attending physician regarding questions about the instrument examination.
Elevated intraocular pressure can lead to optic nerve degeneration, and even with treatment, there may still be a gradual change; if left untreated, the degree of change may occur more rapidly.
Regarding diagnosis and treatment, I apologize, but due to regulations at Taiwan e-Hospital, I cannot provide answers, so it may be necessary to consult the attending physician.

Reply Date: 2021/09/12

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your eye health and the recent OCT results. I understand that managing eye health, especially after a history of trauma and ongoing monitoring, can be quite stressful. Let’s address your questions one by one.

1. TI Part Changes: The changes you are observing in the TI (Total Index) part of your OCT results can be concerning. A decrease in the TI score from yellow to red indicates a potential worsening of the condition being monitored. However, the rate of change can vary significantly among individuals. It's essential to discuss with your ophthalmologist whether this rate of change is typical for your specific condition.

2. Impact of Medication: It is indeed perplexing that your eye pressure increased despite the use of medications like Metrolan and later, Shuran Tan. This could be due to several factors, including the possibility that the medications may not be effectively lowering your intraocular pressure (IOP) in your case. It’s also worth considering that individual responses to glaucoma medications can vary widely, and sometimes a combination of medications or a different class of drugs may be necessary to achieve better control.

3. Control Over the Year: The fact that your IOP has fluctuated and that the OCT results have shown a downward trend could suggest that the current treatment plan is not adequately controlling your condition. It is crucial to have an open discussion with your eye care provider about your treatment goals and the effectiveness of the current regimen.

4. Lifestyle and Supplementation: While you are following a healthy lifestyle by exercising regularly and taking supplements like lutein and multivitamins, these alone may not be sufficient to control eye pressure or improve the health of your optic nerve. Medications prescribed for glaucoma are typically necessary to manage IOP effectively. It’s important to continue following your doctor’s advice regarding medication and lifestyle adjustments.

5. Intraocular Pressure Management: Your IOP readings of around 18 mmHg are within the target range for many patients, but this can vary based on individual risk factors and the specific characteristics of your optic nerve. If your doctor feels that further reduction is necessary, they may consider adjusting your medication or adding additional therapies. Regular monitoring is key to ensuring that your IOP remains stable.

6. Additional Considerations: It’s essential to maintain regular follow-ups with your ophthalmologist, especially given your history of eye trauma and the current changes in your OCT results. Be sure to communicate any new symptoms or concerns, such as changes in vision, discomfort, or headaches, as these can provide valuable information for your doctor.

In conclusion, managing eye health, particularly in the context of glaucoma and previous trauma, requires a comprehensive approach that includes medication adherence, regular monitoring, and lifestyle adjustments. I encourage you to maintain open communication with your healthcare provider, as they can provide the most tailored advice based on your specific situation. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another ophthalmologist may also be beneficial.

Wishing you the best in your ongoing care and management of your eye health.

Sincerely,
Doctor Q&A Teams

Similar Q&A

Concerns About Vision Loss: Managing High Myopia and Eye Health

I am severely myopic (both eyes close to 1000 degrees). In recent years, I have been paying close attention to my eyes while studying, having regular check-ups every three to six months to monitor my retina at an ophthalmology clinic. Fortunately, the doctors have informed me tha...

Dr. He Jianxian reply Ophthalmology
Hello: Basically, you have been undergoing regular check-ups, so there is no need to worry too much. Your work will not cause blindness, and you can feel reassured. Wishing you good health.

Understanding Glaucoma: Key Questions and Concerns for Patients

Dear Doctor, My father experienced blurred vision in his left eye about six months ago and initially visited a local clinic. The doctor diagnosed him with cataracts, but stated that it had not progressed to the point of requiring surgery, so my father only used eye drops during ...

Dr. Gao Pilin reply Ophthalmology
Hello Mr. Wang: 1. Visual field (VF) testing is a passive examination. In addition to optic nerve disorders, cataracts can sometimes also affect the results. Optical coherence tomography (OCT) is a subjective method of examination that can reveal the condition of the optic nerve...

Understanding Glaucoma: Concerns and Next Steps for Patients

I had an OCT examination yesterday, and they told me that my values are just a little bit close to glaucoma. What should I do? 1. Will I wake up tomorrow with glaucoma? 2. Once glaucoma develops, will I go completely blind? 3. Is there absolutely no way to remedy a completely dam...

Dr. He Jianxian reply Ophthalmology
The OCT database is compared with the general population, but due to significant individual variability, abnormalities shown on OCT may not necessarily indicate true abnormalities. To accurately assess glaucoma, it is essential to consider intraocular pressure and visual field te...

Understanding OCT Results: What Do Red Flags Mean for Your Eye Health?

Hello Doctor: Before dilation at the ophthalmology clinic, my intraocular pressure was 20, and after dilation, it was 22. The clinic doctor advised me to go to a larger hospital for an OCT and visual field examination, stating that I have a predisposition to glaucoma. After the h...

Dr. Gao Pilin reply Ophthalmology
Hello: The red text is for reference only; the physician's interpretation should be prioritized. If the doctor says there is no problem, you can feel reassured. Pain around the eyes and headaches are likely caused by eye strain. When using the computer, you may consider wear...