Glaucoma: Concerns About Eye Pressure and Follow-Up Care - Ophthalmology

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Suspected glaucoma?


Dear Dr.
Gao,
I am a person who gets easily anxious and have difficulty cooperating with the air-puff tonometer tests.
Previously, due to elevated intraocular pressure (around 21-23 mmHg), I was monitored at National Taiwan University Hospital Beihu Branch for five years, undergoing OCT, fundus photography, and visual field tests every six months.
Eventually, the doctor concluded that I do not have glaucoma (the last examination was in December 2022) and advised me to continue monitoring my eye pressure at a nearby hospital.

This December, during a follow-up at a local hospital, my right eye pressure was measured at 24 mmHg.
The doctor performed a visual nerve scan and mentioned that my right eye is on the "borderline" of glaucoma.
Feeling anxious, I returned to Beihu Hospital.
Since I couldn't get an appointment with Dr.
Wang, I consulted Dr.
Lin instead.
This time, Dr.
Lin used a handheld non-air-puff tonometer to measure my eye pressure, which came out to be 16 mmHg in both eyes.
She then used the standard equipment in the clinic and reviewed the advanced tests I had done last December at Beihu.
After reviewing everything, the doctor said that since I had just undergone a visual nerve scan at Shuanghe Hospital, she could not perform another one at this time and scheduled me for OCT and visual field tests in six months.
I would like to ask: 1.
How often can a visual nerve scan be performed? 2.
If I am indeed on the borderline of glaucoma, will waiting six months for the next examination be too long?
Thank you for your patience in reading this lengthy message!

Xiao Ke, 50~59 year old female. Ask Date: 2023/12/29

Dr. Gao Pilin reply Ophthalmology


Hello: I understand your concerns about eye health.
Glaucoma requires close monitoring and management to prevent potential optic nerve damage.
Regarding your questions: 1.
Frequency of optic nerve scans: Generally, the frequency of optic nerve scans depends on the diagnosis of glaucoma, the severity of the condition, and the physician's recommendations.
For patients diagnosed with glaucoma or those at the borderline of glaucoma, it is typically recommended to have an optic nerve scan every 6 months to 1 year to monitor changes in the retinal nerve.
However, this interval may vary based on individual circumstances, so it is advisable to follow your physician's recommendations closely.
2.
Timing of examinations: If you have been diagnosed as borderline glaucoma, the frequency of follow-up examinations is indeed important.
A follow-up examination after six months can allow the physician to observe any potential changes.
However, if you have concerns about the timing of the examination, you may want to communicate with your physician to see if an earlier appointment can be arranged.
Sometimes, physicians may schedule earlier examinations based on your specific situation to ensure timely monitoring of disease progression.
Timely follow-up and accurate examinations are crucial in glaucoma management.
If you have any questions or concerns about your treatment plan or the frequency of examinations, I recommend proactively discussing them with your physician to ensure your eyes receive the appropriate attention and care.

Reply Date: 2023/12/29

More Info


Hello! Thank you for your detailed questions regarding glaucoma and eye pressure management. It’s understandable to feel anxious about eye health, especially when dealing with conditions like glaucoma. Let’s address your concerns one by one.

1. How often can optic nerve scans be performed?
The frequency of optic nerve scans, such as Optical Coherence Tomography (OCT), can vary based on individual circumstances. Generally, if there are concerns about glaucoma or changes in the optic nerve, it is advisable to have these scans done at least once every six months to a year. However, if there are significant changes or if you are at higher risk, your eye care provider may recommend more frequent monitoring. Since you have a history of elevated eye pressure and have been monitored for potential glaucoma, your doctor will likely tailor the follow-up schedule based on your specific situation.

2. Is waiting six months for a follow-up too long if I am on the edge of glaucoma?
If your eye care provider has assessed that your condition is stable and that your optic nerve appears healthy, then a six-month follow-up may be appropriate. However, if you have concerns about your eye pressure or any symptoms, it’s important to communicate this with your doctor. They may decide to perform additional tests sooner if they believe it is warranted. It’s crucial to maintain open communication with your healthcare provider about your anxiety and any symptoms you may experience, as this can influence the management plan.

In terms of managing your anxiety, it might be helpful to educate yourself about glaucoma and its management. Understanding that many people with elevated eye pressure do not develop glaucoma can sometimes alleviate fears. Regular monitoring and following your doctor’s recommendations are key components in managing your eye health.

Additionally, lifestyle factors can play a role in eye health. Maintaining a healthy diet, staying hydrated, managing stress, and avoiding smoking can contribute positively to your overall well-being, including your eye health. If you find that your anxiety is significantly impacting your daily life, consider discussing this with a mental health professional who can provide strategies to help you cope.

Lastly, regarding the measurements of your eye pressure, it’s important to note that eye pressure can fluctuate throughout the day. Factors such as time of day, stress, and even the method of measurement can affect the readings. Therefore, it’s beneficial to have multiple readings over time to get a clearer picture of your eye pressure trends.

In summary, while waiting six months for a follow-up may seem long, it is often a standard practice if your eye care provider believes your condition is stable. However, do not hesitate to reach out to your doctor if you have any concerns or if your symptoms change. Regular monitoring and open communication with your healthcare provider are essential in managing your eye health effectively.

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