Eye questions: Narrow angles, pressure, laser surgery, and pregnancy

[COElizabeth]

I have been seeing an opthalmologist for a year and a half because I have a family history of high eye pressure and open-angle glaucoma and because I have had high eye pressure at one visit and borderline high pressure at subsequent visits. Thankfully, my visual field tests have been normal, and my eyes have looked normal, so my doctor has just been monitoring me.

Today, though, the resident and doctor agreed that my angles looked a little narrow. They didn't think they were so narrow as to be in danger of closing right now, but they wanted another opinion. So, I am being referred to the clinic's glaucoma specialist for evaluation and possible laser surgery to put holes in to help prevent a buildup of fluid. I have tons of questions and was wondering if anyone could shed light on the following:

1. The doctors said that the eye angle can narrow during pregnancy. Has anyone had this happen? Does it typically reverse after birth?

2. Has anyone had laser surgery to prevent problems with angle closure? How was it?

3. If I had this surgery to prevent closed-angle glaucoma, would it also help lower my eye pressure overall and perhaps avoid my having to take eye drops in the future to prevent damage from the chronic form of high eye pressure (as opposed to the acute rise that could happen with an angle closure)?

TIA for any info from eye experts or those who may have been there!

Elizabeth, Mom to James, 9-20-02
EDD #2, 10-30-04

[Marisa6826]

Hey Elizabeth-

Not an eye expert, but a lifelong myopic ;).

I have problems with my vision when I'm pregnant too. My doctor explained to me that they're very hesitant to make any significant changes during pregnancy because of the high fluid and hormone levels floating in your system. Apparently it changes all kinds of things in your eyes - including the shape of them (since they're mostly water).

I can't wear my contacts at all while preggo otherwise I get this little abrasions on the insides of my lids. That was my justification to the indulgence of new frames :P .

Have you talked to your OB?

-m

[llcoddington]

I have lots of eye experience! My vision is over -10 in both eyes and I am counting the days until I can get laser surgery to correct my vision! (I wore contacts for 18 years and can no longer wear them.)

I haven't dealt with high pressure but have my pressure monitored due to my having to use steroid eye drops to reduce eye and eyelid inflamation. The inflamation started a couple of years ago after having two miscarriages. After having Lauren I developed severe dry eye on top of the chronic inflammation. My eyes get really bad while pregnant and then relatively bad when nursing and I hope better when not! So, I would definitely say that most anything can happen to your eyes while pregnant. :(

My opthamologist (and everything I have read) says you cannot have laser surgery while pregnant or nursing due to your hormones changing the shape of your eye. You might want to ask about that since I see that you are due in October.

You mentioned having to use eye drops. I am assuming you are referring to steroid eye drops? If so, I just want to caution you! I have to use them and I am quite scared of them. I know one girl my age (28) who developed glaucoma and has had surgery on both eyes after using steroid drops. Another woman I know (mid 40s) had cataracts due to steroid eye drop use. Doctors readily hand out prescriptions for these drops and they have MAJOR side effects. I use them because I have no choice. Scary. I try to limit them to a couple of days every few months.

I hope you can get this fixed. I KNOW how bad eye problems are. I certainly took my eyes for granted before all of this mess!

Lana
mommy to Lauren 12/5/03

[Marisa6826]

My eye doc wouldn't even prescribe me the steroid drops because I"m preggo. He told me I'd have to live with the irritation caused by the little bumps under my eyelids - it wasn't worth risking the health of the baby.

Food for thought

-m

[llcoddington]

I should have clarified. Mine wouldn't prescribe them either while I was pregnant. But, once I had Lauren, back to the eye drops! I get those little bumps too. Any idea why we get those irritating things?!

Lana
mommy to Lauren 12/5/03

[chrissyhowie]

I happen to be married to an ophthalmologist :)! I had him read your post and this is the low-down on what he said:

Your eye angle can narrow during pregnancy. So unless you were at very high risk of acute angle closure, it would be recommended to wait until after the pregnancy to do any type of laser surgery, as the changes can spontaneously reverse after the pregnancy. Likely the docs you saw are just being safe by having you see a glaucoma specialist to confirm their findings (that you are not in immediate danger of acute angle closure).

The laser surgery should in most cases be curative, meaning that most people do not need to use the eye drops to lower the eye pressure following having the procedure done. Whether one needs to have the surgery done is kind of a judgement call. It depends on how high your pressures run, which determines your risk of having acute closure. Acute closure needs immediate treatment to prevent permanent optic nerve damage and blindness.

Some of the symptoms of angle closure would be severe headache, nausea and vomiting (hopefully you aren't having these two from the pregnancy!), severe eye pain, excessive eye tearing, seeing halos around objects. If you suddenly experience any of these things, you should get your eye pressures measured emergently.

I hope that info helps a bit.

[Marisa6826]

Lana-

My doc said that it's from the dry lids rubbing against the surface of your eye. I guess kind of like little callouses? Ick!

My contacts were starting to get grooves in them from the bumps, and completely compounding the situation, so I can't wear them till after the baby gets here.

-m

[COElizabeth]

Thanks, Chrissy! I didn't know your DH was an opthalmologist! That is helpful. The doctors both thought the angles were only slightly narrowed and not occludable, so I suspect that the glaucoma specialist will not see an immediate need for surgery, but I will certainly get his opinion. And thankfully, my pg nausea has been gone for a while now, so I will know to be concerned if I suddenly get feel sick again or have the other problems.

And I have somehow missed Miss Sophie's arrival! Congratulations!!!!! How are things going?

Elizabeth, Mom to James, 9-20-02
EDD #2, 10-30-04

[starrynight]

I haven't had any surgery so I can't answer that. But with each of my pregnancies my vision got a little "off" and was fine a few months post partum. Hormones, fluid, pressue all of that effects your vision.

[chrissyhowie]

Yep, I'm finding DH is pretty handy to keep around for more than one reason ;). Ophthalmology was probably one of the few fields I had absolutely NO interest in going into myself. The eye just doesn't do it for me I guess :P.

Sophie arrived at the end of June -- thank goodness because I was really ready to deliver!! I posted a few pics in the Bios/Arrivals sections. I'm doing really great -- thank you for asking! Things seem much easier the 2nd time around -- you're just so much more relaxed about absolutely everything!! I find that I am more amazed on a daily basis by how GIGANTIC Chloe is (where did my baby go -- she's such a GIRL now :)!) versus how tiny and new Sophie is. Chloe is handling all the changes very well. She kisses Sophie whenever she gets the chance, but we have to be ever-vigilant because she ends up poking and swatting at her too! James will have you guys dancing as well LOL!

I'm so glad to hear things seem to be going well with you so far!

[jakobsmommie]

I work for a pediatric ophthalmologist so we don't see too many adults with glaucome, but we do see kids with it.
I agree, it does sound like it is just a precautionary measure. If it was extremely concerning, you would have had the laser treatment that day or shortly after!

Good Luck to you.