Glaucoma Concerns: A Guide for High Myopia Patients

Concern for glaucoma

Hello, Doctor.
I am a programmer with high myopia.
Last year, my intraocular pressure was as high as 26.
The doctor prescribed me a fatigue-relief eye drop, and after three days, my pressure dropped to 18-19 during a follow-up.
Two months later, I went to Hospital A for a visual field test, OCT, and fundus photography.
The doctor said there were no signs of glaucoma.
Over the past year, I have been visiting the ophthalmologist intensively, almost twice a month for pressure checks and once for dilation and fundus examination.
The doctors have all told me that my pressure is normal.
Only once was a small hole found in the fundus, and the doctor said I could choose to have laser treatment or not (I chose to have it).
Recently, I read an article that made me anxious about glaucoma.
At Tri-Service General Hospital, an intern told me that my optic nerve is slightly cupped (which the doctor mentioned during the initial examination).
I went to a regional hospital for an OCT, and the doctor said that the results were acceptable for high myopia (the curve was mostly in the yellow zone).
Later, I returned to Hospital A for another OCT, and this time the results were similar to the regional hospital, except there was a slight indentation in the red zone, which compared to last year, showed a noticeable difference in the OCT.
In extreme anxiety, I went to a clinic and paid out of pocket for an OCT and a simple visual field test.
The OCT results were generally the same as those from Hospital A, and the simple visual field test was fine.
I would like to ask the doctor: 1.
Does the OCT result indicate glaucoma, especially since there are changes visible in the OCT? However, in the fundus photography, the doctor said the vascular pattern looks similar to a year ago, and we need to wait two months for the visual field results.
But I am already extremely fearful and anxious.
2.
I don’t understand; my family has no history of glaucoma.
Can excessive eye fatigue lead to glaucoma? 3.
If I diligently take my medication and attend follow-ups, can I preserve my vision for the rest of my life? Many people say that glaucoma patients lose much of their vision after 20 years.
4.
Can I still go to the movies? 5.
If I unfortunately develop glaucoma, is it best to give up my job as a programmer? I apologize for the lengthy message, but I am really worried, and I hope the doctor can provide me with some advice and education.
Thank you.

John, 20~29 year old female. Ask Date: 2014/07/08

Dr. He Jianxian reply Ophthalmology

1.
OCT results do not fully represent the presence or absence of glaucoma and must be interpreted in conjunction with other conditions.
2.
There are no clinical reports linking excessive eye strain to the development of glaucoma.
3.
Essentially, if glaucoma has not been confirmed, your concerns are unnecessary.
4.
Watching movies is certainly not a problem.
5.
Even if you are diagnosed with glaucoma, there is no need to give up your current job.

Reply Date: 2014/07/08

More Info

Understanding glaucoma, especially for individuals with high myopia, is crucial due to the increased risk of developing this condition. As a high myopia patient, your concerns are valid, and it's essential to address them comprehensively.

1. OCT Results and Glaucoma Diagnosis: Optical Coherence Tomography (OCT) is a valuable tool in assessing the health of the optic nerve and can help detect changes that may indicate glaucoma. However, OCT results alone cannot definitively diagnose glaucoma. The diagnosis typically involves a combination of factors, including intraocular pressure (IOP), visual field tests, and the appearance of the optic nerve. The fact that your IOP has been stable and that your visual fields have been normal is reassuring. Changes in the OCT results should be monitored over time, but they must be interpreted in conjunction with other clinical findings.

2. Family History and Eye Fatigue: While a family history of glaucoma is a significant risk factor, the absence of such a history does not eliminate your risk, especially with high myopia. Eye fatigue itself does not cause glaucoma, but it can lead to other issues such as dry eyes or temporary discomfort. It's essential to manage eye strain, particularly if you spend long hours in front of a computer screen. Regular breaks, proper lighting, and ergonomic setups can help alleviate fatigue.

3. Medication and Vision Preservation: Adhering to prescribed medications and attending regular follow-ups is crucial in managing eye health. If glaucoma were to develop, early detection and treatment can significantly slow its progression and help preserve vision. Many patients with glaucoma lead normal lives with appropriate treatment. The fear of losing vision is common, but with proper management, many individuals maintain their sight for years.

4. Leisure Activities: You can continue to enjoy activities such as watching movies. There are no specific restrictions on leisure activities for individuals at risk of glaucoma, as long as you manage your eye health and follow your doctor's recommendations.

5. Career Considerations: If you were to develop glaucoma, it does not necessarily mean you must abandon your career as a programmer. Many individuals with glaucoma continue to work in their chosen fields. The key is to manage the condition effectively and make any necessary adjustments to your work environment to accommodate your visual needs.

In summary, while your concerns about glaucoma are understandable, it is essential to focus on the positive aspects of your current eye health. Regular check-ups, adherence to treatment, and maintaining a healthy lifestyle can significantly contribute to your overall well-being. If anxiety persists, consider discussing your fears with your eye care provider, who can provide reassurance and further education about glaucoma and its management. Remember, knowledge is power, and staying informed about your condition is the best way to alleviate fears and maintain your vision.

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