My Pressure Story: Sight That Is Lost Is True Hindsight

Stephanae McCoy

I’m not talking about diastolic or systolic pressure, as in hypertension or high blood pressure; instead, I’m talking about eye pressure, as in glaucoma – a silent, sight-robbing thief. I shouldn’t have been surprised when my retina specialist finally diagnosed me with primary open-angle glaucoma.

After all, my maternal grandmother had the same condition and was on eye drops for as long as I can remember. The fact that glaucoma is hereditary, along with the fact that I’m African American, meant that I knew there was a possibility I could be genetically predisposed to acquiring this condition. I also knew, because of my grandmother’s situation, that left untreated, this eye disease could cause blindness.

For most of my life my vision was correctable with lenses, to what is considered regular, or 20/20, vision. Then, almost nine years ago, I started having problems with my sight due to high myopia with secondary findings of macular holes which left me without central vision.

Waiting for a Diagnosis

Glaucoma, as I later learned, affects peripheral vision and in my specific situation, was caused by sustained increased pressure inside the eye. Because I had macular holes and other retina issues, my retina specialist and ophthalmologist felt that my increased eye pressure could have been a result of these complications.

Since it can take considerable time to come to a definitive diagnosis, I was monitored for a number of months before it was decided that I needed to go on glaucoma drops. Xalatan, a medication that lowers eye pressure by relaxing the eye muscles to allow better drainage and improve the outflow of fluid, was the first glaucoma medication I was given. It worked well, but the moment I finished the trial period, my pressure increased dramatically.

It was at this point that my retina specialist determined that I had primary open-angle glaucoma and I would need to take medicine for this condition for the rest of my life.

That diagnosis was about six years ago. I didn’t take the prognosis seriously at first, but I would in good time.

No Glaucoma Symptoms

Like most people who have glaucoma, I never had any symptoms. While my remaining vision was only 20/600 in my left eye and finger counting in the right eye, it’s likely I wouldn’t notice more sight loss, or so I thought. I had an episode last year when, after missing a couple doses of my eye drops, my sight got so distorted that it took my breath away. I made an emergency appointment with my ophthalmologist and the pressure in both eyes was well into the 40s. I was told previously that normal is considered a range of 10-20.

(Note: Most eye care professionals define the range of normal intraocular pressure as between 10 and 21 mm Hg [i.e., millimeters of mercury],which is a pressure measurement).

Because my eye pressure was so very high, my doctor prescribed two new eye medications. One was Combigan, a combination of brimonidine, an adrenergic agonist, and timolol, an adrenergic blocker. The other was Zioptan, or tafluprost, that reduces pressure in the eye by increasing the amount of fluid that drains from the eye. The combined medications worked well in bringing down my pressure and I haven’t had any further glaucoma-related issues since.

Sight Lost Really Is Hindsight

While vision loss can occur with glaucoma, going completely blind is rare. It remains vitally important, especially for people over 40 years of age or in high-risk groups, to get regular, dilated eye examinations. Another critical piece of advice is to take all diagnoses seriously and perform due diligence. This includes asking questions and making sure you are satisfied with, and totally understand, the answers to your questions. You may want to get second or even third opinions.

While glaucoma was not initially responsible for my vision loss, I am serious about maintaining my remaining vision. Had I not been under the care of several eye physicians for the macular holes it’s conceivably possible that I may not have learned I had glaucoma. This eye disease is so insidious that by the time you realize you can’t see very well it may be too late so see your eye doctor regularly, get a dilated eye exam, and keep up with your prescribed treatment plan.

More Glaucoma Information

Be sure to read the VisionAware blog and related articles for more information on research about glaucoma treatment, including a promising new method for administering glaucoma medication.