Q. What can be done to manage vision and headaches in glaucoma with astigmatism?

Answered by
Dr. Rahul Vaswani
and medically reviewed by Dr. Divya Banu M

Hi doctor,

I am 48 years old, female. I have been diagnosed with starting glaucoma and I have all OCT scans and glaucoma screening results. I would like to know what precisely is happening with my eye. I had a bad vision already for 3 to 4 years and was wearing glasses but now it is not comfortable to wear. I also have astigmatism. I struggle to see now clearly and have constant headaches. Please let me know if you can diagnose and see what problems I am facing.

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Dr. Rahul Vaswani

MASTER IN SURGERY OPHTHALMOLOGY
Ophthalmology (Eye Care)

Hi,

Welcome to icliniq.com.

OCT is normal. Glaucoma is in very early stage (attachment removed to protect patient identity) but you have not mentioned your intraocular pressure forastigmatism. I would suggest these options:

1. Toric contact lenses. A non-surgical procedure but contact lenses require constant care.

2. LASIK surgery preferably PRK LASIK surgery is one of the best options now but coming to my third option, phasic lens extraction and replacement with toric multifocal lenses.

Option 3 is preferable because 10 years down the line you will be needing a cataract surgery anyways. For glaucoma point of view please tell me your intraocular pressure readings.

Hi doctor,

Thank you for your reply. Can you please suggest what checks are required to see intraocular pressure?

Dr. Rahul Vaswani

MASTER IN SURGERY OPHTHALMOLOGY
Ophthalmology (Eye Care)

Hi,

Welcome back to icliniq.com.

It can be checked through various small tests. The most accurate bieng applanation tonometry.

Thank you doctor,

Okay, I will try to do that test tomorrow. And send you the details. For now, please also check these following results.

I also have other results which is cornea- transparent, norm of tear firm-7c and Shirmer- 35 mm, ocular fundus- excavation 0.5 to 0.6, keratometry OD- 42, 50-5, 43, 50-95, OS-42, 50-177, 43, 75-87, pachymetry OD- 394, OS- 368, macular and posterior pole degeneration (H 35.3).

Dr. Rahul Vaswani

MASTER IN SURGERY OPHTHALMOLOGY
Ophthalmology (Eye Care)

Hi,

Welcome back to icliniq.com.

The only thing to worry here is your corneal thickness less than 400 which basically rules possibilities of LASIK surgeries. Astigmatism is there but it is not such a big thing to worry. I mean corneal thickness is a bigger issue. Shrimmer is near normal and optic disc health is slightly above normal range but not something to worry. I advise you to get intraocular pressure done yearly or if possible, six-monthly follow up to repeat glaucoma-related investigations 1.

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