How to treat glaucoma with type 2 diabetes?

Question

Hello doctor,

I am a middle-aged male with type 2 diabetes. I consulted an ophthalmologist following a referral from an optician with a bilateral elevated IOP of 28 mmHg. The consultant determined I had corneal thickening. He discharged me with no recommendations for monitoring. I was diagnosed with non-tension glaucoma in both eyes. I have since been told that I should be on a monitoring schedule and if I had glaucoma it would have been detected early and my now advanced sight loss would have been less critical. The ophthalmologist told that me I should have been regarded as suspecting glaucoma and recalled for testing every 12 months. He also told me that I should have had a gonioscopy. Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

If a patient is a glaucoma suspect, then it is imperative to follow-up meticulously. The following tests may be performed on an annual basis.

Intraocular pressure using GAT (Goldman applanation tonometer) or DCT (dacryocystectomy).
Visual field assessment.
Retinal nerve fiber thickness and optic disc evaluation.
Gonioscopy.

Also, certain conditions like blood pressure or sleep apnea have been implicated in normal tension glaucoma. Your ophthalmologist can now start you on strict eye pressure control and may also offer you some surgical options like express shunt, to keep eye pressure under control. Do consider the above tests at regular intervals now. If a diagnosis of glaucoma is made then once in three months IOP (intra-ocular pressure) assessment would be good after the stabilization of IOP.

I hope this helps you.

Thank you for consulting me.

You can always come back and reach me at icliniq.com.