Glaucoma suspect

Those in the holistic healthcare field often believe they should enjoy perfect health themselves – that the right lifestyle and mental outlook should prevent any problems developing, but that even if something does go wrong it can be corrected by natural therapies, without recourse to orthodox medicine or surgery. Such beliefs were challenged for me when, as a ‘glaucoma suspect’, I was referred for LPI – laser peripheral iridotomy. However, my experience so far has been positive and maybe my story will be helpful to others considering this operation.

The only reason I went to the optometrist was that my driving license was due for renewal. It was quite a shock to be told that my vision was not so good as I thought it was, and that my intra-ocular pressures had increased to well above the normal range. I was diagnosed as having ‘narrow angles’ between the lens and the iris. This condition, which blocks the free drainage of aqueous fluid, may or may not progress to either acute or chronic glaucoma. I was referred to a specialist who gave me the choice of either having regular repeat observation, or LPI to create a tiny hole in each iris so allowing the fluid to circulate.

The prospect of an operation, however minor, on such an important and sensitive body part as the eyes was daunting. In general, too, I am wary of medical interventions based on screening tests rather than clinical symptoms. I spent some time researching LPI on Google. Most sites described it as a very safe and successful procedure with only a small risk of side-effects, but I found two separate reports from patients who claimed to have suffered devastating visual damage as a result of this operation. These cases were clearly quite atypical, but still alarming.

I also researched natural approaches to preventing glaucoma. I was already doing most of the right things – not smoking, walking several miles daily, eating plenty of fruit and vegetables – and seldom drinking more than one cup of coffee or one glass of wine per day. My homeopath suggested that walking barefoot on green grass would help relax the eyes and I found this a very pleasant exercise, apart for the time an enthusiastic large dog jumped onto my foot.

Eventually, weighing up the pros and cons, I decided that because visual loss from glaucoma is irreversible, I would accept the preventive surgery.

LPI is an outpatient procedure. On the day, a technician prepared my eyes with two kinds of drops: a local anaesthetic, and pilocarpine to constrict the pupils. Then I had to wait about half an hour, during which time my vision was slightly blurred and I felt rather shaky probably due to a mixture of pilocarpine and nervousness. This was the worst part of the whole experience.

The operation itself took only a few minutes, and the technology was impressive. My chin and forehead rested forward against a frame while my surgeon, seated opposite, applied more local anaesthetic to my right eye and inserted a special lens to prevent blinking and to magnify her view of the iris. She asked to to look straight ahead and then applied a series of laser shots in quick succession. I perceived these as starbursts of red light. They were uncomfortable rather than painful.

The same process was repeated on my left eye, then after a short rest in the waiting room I was ready to leave the clinic and have lunch in a nearby cafe with my husband, who had come with me to provide welcome moral support. I would not have been allowed to drive myself home after having both eyes treated on the same day, though driving is permitted for patients who have had only one eye done.

To my surprise I experienced no after-effects whatever, and felt no need to use the anti-inflammatory eye drops I had been given. Having expected to need a longer recovery period, I had planned to cut down on reading, writing, computing or watching movies for a few days. This involved some pleasant alternatives – including a tour of the vineyards of Waiheke Island. However it was quite a challenge to find activities which did not require use of the eyes, and this made me very conscious of the importance of sight.

At my six-week follow-up appointment I received the good news that my eye pressures were down and the intra-ocular appearances improved. While the long-term outcome remains to be seen, so far it seems that orthodox treatment has been worthwhile.

Update: Two-and-a-half years later, optometry checks every six months continue to show pressure readings above the normal range, but they are no worse than before and all other measurements are satisfactory. No further treatment has been recommended and I hope that a ‘healthy lifestyle’ and ‘positive outlook’ will keep my condition under control.