Glaucoma Treatment: Improve Eye Pressure Reduction and Compliance!

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This video will help you maximize eye pressure reduction and compliance in your glaucoma patients, using as few daily eye drops as possible! This video was designed as a blueprint to determine which drops to use first and why, and how to switch medications while also not burdening the patient with having to take a ton of eye drops every day. I go over all the drops commonly used like latanoprost, timolol, dorzolamide, brimonidine, cosopt, combigan, simbrinza, vyzulta, rhopressa, Rocklatan
This advice is based on the combination of my experience as a resident at the Orlando VA Medical Center, as well as my schooling at Nova Southeastern University College of Optometry.
I do not own the copyrights to any images in this video, they were obtained from Google images and simply consist of images of the various glaucoma eye drops.
Sources:
-Residency Experience at the Orlando VA Medical Center
-Dr Joseph Sowka’s glaucoma course lecture notes
-KMK NBEO Part 1 Study Guide
Link to How to Pass NBEO Part 1 video: • How To Pass NBEO Part ...
Link to How to Pass NBEO Part 2 video: • How to Pass NBEO Part ...
Link to How to Pass NBEO Part 3 video: • How to Pass NBEO Part ...
Link to How to Pass NBEO Part 3 troubleshooting video: • I Failed NBEO Part 3, ...
Facebook: Andreas Zacharopoulos
Instagram: andreaskmk
Email: doctorandreas94@gmail.com
Images URL-
Lumify-images-na.ssl-images-amazon.c...
Vyzulta- www.vyzulta.com/Portals/53/Im...
Dorzolamide-www.hexal-elements.de/sandoz_...
Xalatan-www.xalatan.com/sites/default...
Rocklatan-eyeworld-websupport911.netdna...
Timolol-www.sigmapharmaceuticals.com/...
Combigan-www.combigan.com/Patient/asse...
Cosopt-www.svpmeds.com/wp-content/up...
Simbrinzas3.amazonaws.com/pharmacytime...
Alphagan-www.allergantechalliance.com/...
Pilocarpine-lh3.googleusercontent.com/pro...
Diamox-www.sigmapharmaceuticals.com/...

Опубликовано:

5 июл 2024

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Комментарии : 150

@Dashulkin 3 года назад

Great lecture Andreas! 👍🏻

@andreasoptometry 3 года назад

Thank you! Glad you like it! :))

@ghollyvideos219 2 года назад

Current optometry student, super cool to see a new doctor creating something so substantive. It’s might be a relatively niche audience, but it’s a breath of fresh air in a sea of medical tiktok shorts, corporate shill content, and lifestyle vlogs... It’s much easier to do that other stuff, so I wanted to say I respect the work you’ve done and it’s genuinely helpful info. Cheers!

@andreasoptometry 2 года назад

Wow such kind words 🙏🏻🙏🏻. I’m so glad that it’s helpful! I know it’s been a while since my last video but your comment is one of the things that motivates me to eventually get back into making these videos.

@gingerengels3659 3 месяца назад

I became allergic after a year to the preservatives in Latanoprost. I had been on Bromidine twice a day and Latanoprost once at night. I went through five weeks of hell trying to cope with horribly blood red, sore, swollen eyes to figure out what was going on. Finally, I tried going off both meds for a week, and almost overnight, my eye issues ceased. I'm now on preservative free 😊single use vials of generic Cosopt (Dorzolamide and Timilol). So far, so good.

@Dashulkin 3 года назад

Very informative!

@1hctz8 Год назад

I had been taking Combigan twice daily & Latanoprost once in the evening since about last June, but have been experiencing bloodshot eyes over the last several weeks, I had an appointment today & my Opthamologist believes it's an allergic reaction to the Combigan, I was advised to discontinue both, and was given a sample of Rocklatan, but also have a consult May 1st for Cataract surgery to increase drainage in the right eye as my OP was 23 & 17 in the left. I was also advised to use Systane but to take that and the Rocklatan 15 minutes apart. My Dr also said there was dryness & irritation.

@gigihammerstein5944 8 месяцев назад

Thank you for your competent presentation.Horrible diagnosis

@andreasoptometry 8 месяцев назад

Thank you for liking the video. Unfortunately glaucoma can cause blindness if not managed :(((

@paulcampbell6791 3 года назад

Thank you

@timparker9174 3 года назад

Thanks!

@joans5619 6 месяцев назад

I am on rhopressa and a specialty pharmacy RX of a combo of 4 drugs. Left eye is at 14 but right is at 25. I was on xalatan and a combo of dorzolamode-timolol since 2009. Worked fine until 2022. Tried these new drops for a year but had additional vision loss in right eye. Now I am 63 and have psudoexfoliation as well as normal tension glaucoma. I have a cataract so may account for visual field vision loss somewhat. I am going to get cataract surgery and gel stent implant hoping to bring that pressure down. I am scared because I don’t know what will happen with cataract surgery and psudoexfoliation surgery. I have read it’s risky. I’m just at a loss. I have never ever forgotten one drop ever in all these years. I have a touch of ocd and wouldn’t forget. I’ve had a few SLT. They worked until they didn’t. It always creeps up.

@dikshaprajapati9828 10 месяцев назад

Hi Dr. I am from New Delhi India, I am suffering from high pressure in left eye since 6 months. 10 years ago i was injured from the broken side mirrior of the car while driving. After one year i got the cornea surgery some scar visible over the cornea. And after 8 years in 2022 suddenly eye red and visit the my Dr. And he did again surgery with IOL after cataract surgery my vision is going blurr and now i am suffering from glaucoma. My pressure is left eye 47-11 right eye in normal range. Again i got laser surgery from other Dr to control IOP but after sometimes IOP suddenly increased and very painful. Now i am using Simbrinza 2 times in a day with properly timing. What i should do for better relief. I am a 30 years old and doing work on PC. Appreciating you for well knowledgeable video.

@TheJoan48 7 месяцев назад

I've been through the glaucoma mill since 1992. Pretty accurate on what the various eye drops do to us. I'm currently on Timolol PF, Azopt and Rhopressa. I have trouble with exhaustion and am on other drugs for other medical problems. I'm wondering now if Timolol is affecting my heart because I have a heart murmur, but I digress. My main point in writing is that Rhopressa is a bear to take. It causes tearing that can be major. I know this because it does it to me and my pharmacist agreed that patients find it rather difficult to live with. I've got to change to something else. I'm wondering what you've researched about glaucoma being called diabetes of the brain. Plus there's new research out now that the microbiome is the basic instigator in disease formation in the body. I sure would like to hear any input on that. I watch Jesse Chappus' site on RU-vid. He interviews researchers about the latest medical solutions coming in the future. I heard about a doctor doing research putting insulin drops directly in the eye but that was before covid. I wonder what happened to that.Morer research required. I found your talk interesting.

@andreasoptometry 7 месяцев назад

Thank you for watching. Yeah Rhopressa is not my first choice because of $$$ and of redness/dryness/tearing it can cause. But it is effective. Glaucoma treatment can be tough because all drugs are different and a lot of times you can’t take certain meds due to allergies, side effects, $$$$, etc Yeah glaucoma is a slow neurodegeneration of the optic nerve, and in some cases it can be exacerbated by diabetes or hypertension. I’ve heard about studies like those for a long time but until I see some good results from trials, new research ends up being just noise.

@diannethomas6069 3 месяца назад

Am using travatan, do I have to use this all the. Time.

@1hctz8 2 года назад

I had a left eye LPI on 5/2722 & a right eye LPI on 6/10/22, but had a follow-up on 6/23 and unfortunately the procedures didn't work as my readings were 21 in left eye & 23 in right eye. Prior to my procedures I was taking Timolol Maleate & Latanoprost once in each eye daily for several months. My Opthamologist prescribed Combigan & gave me a sample , using twice daily in addition to Lantanoprost. discontinued Timolol as it's included in Combigan. will see my Opthamologist in a month to see how it's working or not & I am compliant with my medications.

@andreasoptometry 2 года назад

Hey Tim, I’m sorry the LPI didn’t work for you. Combigan is a strong combination drug so hopefully it helps with the pressure reduction

@brucewayne-cave 9 месяцев назад

God video, thanks... So. WHY does Travatan Z give you 32~ days of drops (1 drop in both eyes/day); vs Travaprost which only gives you a 25 day supply, no matter how stingy I apply it? PS Rant: The Travaprost bottle it very hard to squeeze and falls out the tip via gravity.

@djpookie2000 2 года назад

Dr. Andreas, I need your opinion. I had a scleral buckle installed in my right eye in 2016. In 2021 my pressure in that eye has been slowly increasing. I am currently using Timolol twice a day, Simbrinza 3 times a day, and Latanoprost before bed. The pressure in that eye ranges from 20 to 27 in that eye when I use those 3 drugs. My doctor changed the Latanoprost to Rocklatan a few days ago. The Rocklatan has made my eye very red. I have not been back to my doctor to see the results of Rocklatan. Are there any other drop cocktails you think I should consider. I am trying to avoid surgery since the retina is fragile due to the detachment in 2016. Thank you for sharing your knowledge in the above video. It helped me a lot.

@andreasoptometry 2 года назад

Hi James. I’m sorry to hear about your challenges. Using multiple drops can be a nuisance. Those are all good drops that you mentioned. Rocklatan is great too but unfortunately it’s major side effect is redness. An alternative to Rocklatan is Vyzulta. Very effective, but quite expensive (although I think Rocklatan is too no?). I don’t know any other combination drugs.

@djpookie2000 2 года назад

@@andreasoptometry I really appreciate the response. I have good doctors, and they said the same as you. You are passionate about your career, so I thought you might be a good person to ask. Good luck, I'm sure you will be successful.

@chrism.313 Год назад

I had to get laser eye sx to lower the pressure in my left then the doctor recommend the other eye as well even though I was only having issues with one eye. I’ve been taking timolol eye drops which has helped keep the pressure down but last visit the pressure was around 26 and recommended to start taking a stronger eye drop timolol and brimonidine combination for one eye only. I was reading there so many side effects to both of those medications like causing heart failure and loss of vision which is scary. I don’t want to take these anymore and looking into natural supplements for eye pressure. I also like to have a coffee before work which helps my day so much but now I can’t cus it raises the pressure and hurts my eye. You think it’s ok to keep taking these eye drops or is there any to any side effects

@andreasoptometry Год назад

Hey Chris! Timolol is pretty safe! While it’s not recommended for people with lung issues or a low heart rate, it is pretty effective at lowering eye pressure. Remember, eye drops are topical medications, which means they are much less likely to cause systemic side effects versus an oral pill. Brimonidine is pretty safe too, it just tends to irritate the eyes in SOME patients. But I have many patients on both those meds that are doing fine. Therefore, I would still recommend that you listen to your eye doctor and take those eye drops. Unfortunately there are not many great PROVEN natural methods of lowering eye pressure, so eye drops are the best we got

@Steph_7d7 Год назад

Would multiple collapsed lung episodes from 15+ years ago still count as a lung issue with regards to timolol use today. i wouldnt want to have another collapse or create a new issue in my lungs by using timolol. Thanks for sharing your knowledge its definitely appreciated

@andreasoptometry 11 месяцев назад

Oof, I would consult your pulmonologist/PCP but I would definitely be reluctant in prescribing timolol, even though it’s a topical drop and not as likely to get into the bloodstream. But I’d definitely ask your doctors first!!

@angelaclements1244 Год назад

Ive just started taking drops at night as dr said i have ocular hypertension. I had op for glaucoma 11yrs ago and only recently had any problems. Dr said its chronic and i must now start taking. drops. But how can something thats been fine for 11 yrs be chronic.

@pauldavidfassam7042 Год назад

I am a 76 years old sufferer of Glaucoma - discovered some 30 years ago, when my older sister was diagnosed. Sadly she is now totally blind. We did find that this disease seemed to be passed down though our mothers side of the family - a number of our 'old' uncles and aunts went blind in the 1950s. I have an excellent Eye Doctor, he has laser treated my eyes twice in the past 3 years in an effort to reduce the eye pressures - and it seems to work. I am taking 1 drop of Xlatan every night and two drops of Cosopt twice a day (approx 12 hrs after) After watching your video, I wonder if I should leave a little time between the two Cosopt drops? My eye pressures were 11 and 12 three months ago. I have recently seen on Facebook, a supposed 'wonder' supplement which apparently stimulates T-cells to repair the Optic Nerve damage after about 3-months - I assume this is a Scam?

@mumtaz8 3 года назад

Good handsome doctor. I am using timolo (1+1) for the last 20 years but a year ago my doctor added letanoprost (1 drop at night). While iop is under control but right is getting blind day by day. Any advice.

@andreasoptometry 3 года назад

Hi Mumtaz! So sorry to hear that :(. Glaucoma meds can help lower the eye pressure but unfortunately even then theres still the chance that vision can get worse. Assuming there’s no other diagnosis, the next step would likely be to add another drop. But every patient case is different so that is a discussion for you to have with your eye doctor for all your options going forward

@andengventurestime7027 2 года назад

Hello doc, I’m Andrea. Saw your videos about glaucoma. I was diagnosed open angle glaucoma last January this year then having some eye pain comes and goes. When I came back to my ophthalmologist here in Philippines he did some tests again the oct and vft to find what’s the problem found out my angle was already closed. So I was diagnosed with chronic angle closure glaucoma then he did some laser iridotomy to me last 16th December. Now its been almost 2 weeks since the laser done but last Saturday I’m having some eye pain again in my right eye. I wonder why it hurts again. Is there possible for the hole to be closed again? By the way I used alphagan for 6 months then switched to timolol because alphagan is so expensive.

@andreasoptometry 2 года назад

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@hiitsmeemi 8 месяцев назад

@@andreasoptometryhow are you now? Are you cured? Update please, thank you

@mamamarvin6770 7 месяцев назад

@@andreasoptometryplease sir I need ur help l am in Nigeria

@forextube5410 3 года назад

Hi.. I got G.A.T.T eye surgery 1 year ago..my eye pressure went down from29 to 10 .. but after a year now, 19 , and the surgery is failed and 2 eye drops , lumuga and azarga we added is not working either. I was told to get an XEN surgery ,, I was wondering what should I do ? any medication ? never used vyzulta u mentioned ,,and I dont undersand why my GATT surgery did not last long effective .. lifting heavy or driving can be a reason ?

@andreasoptometry 3 года назад

Hi, so sorry to hear that :/. Sounds like the surgery worked pretty well initially! I don’t know why it’s higher now, but that can happen some time after glaucoma surgery. Glaucoma is defined by damage to the drainage area of the eye over time, causing eye pressure to go up and damage the optic nerve over a long period of time. So you could have done everything right and still the eye pressure may be high a few months or years after the surgery . The surgery was still a success because it lowered your eye pressure for a while, DELAYING damage. However, since the pressure is back up, I would continue care with your glaucoma specialist. If you want to try any new eye drops, let the doctor know. They know your medical history better than anyone else. Vyzulta is great, in the US is hard to obtain because it’s expensive from medical insurance, but ask your eye doctor about it. Best of luck.

@CarbageMan 7 месяцев назад

Compliance was initially a problem. I put an Expo marker chart on my refrigerator to remind me to take Timolol and assure me that I did. I ended up getting SLT after about eight years anyway.

@andreasoptometry 7 месяцев назад

SLT has now become a primary treatment method for that reason. If I had mild glaucoma, I’d probably just get SLT first to see if I can avoid having to take eye drops.

@CarbageMan 7 месяцев назад

@@andreasoptometry I found it a bit frightening and I haven't been examined yet for the result, but other than using a steroid drop for a week and and a temporary minor itch, it feels as though I hadn't had it done. I'm looking forward to seeing how well it works/worked.

@2tennhills 12 дней назад

I take Iyuzeh . It has not changed my numbers ,but I do have less irritation. Do you. It gives me 19 and 24.

@cheshmehf3361 10 месяцев назад

Hi doc Iam 70 years old my left eye have kind of infection which causes high pressure in my eye my doctor gives me acyclovir 400 and 2 each day and also using drops in one eye please advise if there is any alternative thaks

@igigigugujfjfufug453 Год назад

I am using all of the 3 group of medications and i am 37 years old Did you think doc that i must make laser or surgery coz i got recently macular oedema in one eye God bless you

@nettie-615 Год назад

IHi I’m from Australia. have been using Alphagan P 3x a day, plus Saflutan at night, and Refresh or ? 2x a day! for about10 years now! But it’s true what you say 😢 my eyes always itchy,dry, and RED! I see my ophthalmologist 2 a year because my pressure is under control! 9/12 from 15/24. She also done the iStent inserted in the optic nerve? And.. and.. I get so confused? But funny on the one hand! But problem is I sometimes see spiders ! That’s a problem! She said to go in emergency at once? Should try another eye drop to take away the redness! Thanks

@hiitsmeemi 8 месяцев назад

Happy that your eye pressure is now controlled.

@shawnjames5365 2 года назад

Hi my name is Shawn I've been diagnosed with uveitis I was put on to those eye drops what helps if I can't make it to the doctors 🕺 .

@andreasoptometry 2 года назад

Hi Shawn, sorry to hear about your diagnosis. If you have uveitis, then yes your eye doctor will put you on eye drops to help calm the inflammation. Unfortunately there is really nothing else you can do other than keep using the eye drops and continue seeing your eye doctor. That way, they can let you know if you need to continue being on the drop vs tapering down slowly off of it. I have seen cases where the patient thought their uveitis was gone because they felt a lot better, so they stopped the drops on their own and unfortunately the uveitis returned. So deff keep using the drops and see your doctor for a follow up!

@satishgupta7307 3 года назад

I have using Alphgan Z for about 2 years. However, in the non availability of Alphagan Z in Australia, I stated using Alphagan P. I noticed redness, itching, feeling of foreign thing in eyes. Optician and Eye specialist, here feel it may be due to changing from Alphagan Z to Alphagan P. Now, eye specialist has advised use to Xalatan . Please advise. Thanks.

@andreasoptometry 3 года назад

Hi Satish! Sorry to hear that! It’s rather odd that Alphagan P Is causing redness, as it is almost identical to Alphagan Z (they both have Purite as a preservative). However, it IS possible that Alphagan P can give you a reaction instead of Z. Alphagan by nature i feel like is just bound to eventually cause redness on a patient. On a new patient that I just diagnose with glaucoma, my first medication that I would try IS Xalatan, as it is more effective. So, if I were you, I would follow your eye specialist’s recommendation and try xalatan and go from there. I don’t know about Australia, but in the US, xalatan in the generic form is sold as latanoprost, which is like $7-10 a bottle, not bad

@satishgupta7307 3 года назад

@@andreasoptometry Thank you very much for the prompt reply. Really great. I will start using Xalatan . My IOP is 15 to 20 both eyes for the last 2 years with Alphgan Z. Recently, my optician revealed that I have grade 2 Cataract also. My age is 71 years. Kindly advise in this regard also. I will further appreciate if you can suggest some anti inflammatory or anti allergy eye drops for itchy, dry, red, watery painful eyes. Thanks and regards.

@andreasoptometry 3 года назад

You’re welcome! If your eye doctor has said that you’re not ready for cataract surgery, you’re probably not. Because even if the cataract is dense, if your vision is good and you can function to do your daily routine, you’re good. I like to not recommend cataract surgery unless it’s bothering you a lot. It’s the most common surgery in all of healthcare though so when the time comes and you can’t see at all even with glasses (could happen 1,2,5,10 years or never it just depends) then your eye doctor will recommend for you. As for red/dry/itchy eyes, any lubricating drop 2-4 times a day should be good (such as refresh or systane) should help out. Avoid visine or any “red eye drops”. Lastly if you have allergies and your eyes itch all the time, over the counter pataday or Zaditor or alaway can work as well. These are all questions that your eye doctor can go into more detail if necessary :)

@satishgupta7307 3 года назад

@@andreasoptometry Thanks and regards.

@jimrusch22 Год назад

I have been diagnosed with OAG 15 years ago. I’ve been on a combination Latanaprost and Trusopt for years IOP from 22 to 18. Field of vision has worsened. Tímolol a beta blocker dropped the IOP to 16 but I developed severe asthma as a side effect. SLT twice with Trusopt has maintained pressure between 16 to 18 but the doctor is seeing further deterioration of my field of vision. Recently he trialed Roklatan which lowered the pressure to between 12 and 14. It does cause red eye and the cost is expensive but it does indeed work well for me.

@alvin-D-elliott Год назад

I was diagnosed with open angle glaucoma 14 months ago. In those 14 months, I have gone from one medication to 4 medications. Is laser treatment next? I am taking Rocklatan and Timolol/Dorzolamode. My eyes are red but a little better with lumify.

@andreasoptometry 11 месяцев назад

Has your doctor talked to you about SLT laser? Definitely an option to consider and pretty noninvasive

@alvin-D-elliott 11 месяцев назад

@@andreasoptometry Yes we have discussed SLT being the next step. I have a visual field test coming up in a few weeks and if things have become worse, SLT it will be.

@nandoaikman4213 2 года назад

is the glaucoma medications still effective if it was exxidentaly frozen and defrost?

@willgordon5737 7 месяцев назад

Freezing and thawing the can alter their composition and effectiveness

@tomlam3680 7 месяцев назад

I am currently using Travoprost for my eyes, I am supposed to use it one drop per night, I have noted every time I use this eye drop, my eyes are red for 2 to 3 days. I am not consistently taking the eye drops one drop per night for that reason. I spoke with my doctor asking for switching to another eye drop, he told me to continue with this Travoprost. I am worrying that I don’t take this eye drop, my eyes will get worse, but If I use it, my eye are red. I need some advice. Thank you

@andreasoptometry 7 месяцев назад

Yeah unfortunately redness is a common side effect of the travoprost. I’m not your doctor so I obviously don’t know your history and you should follow your doctor’s advice. Glaucoma can cause irreversible blindness so if you’re on drops, they should be taken as indicated. From a cosmetic standpoint, you could ask your doctor if Lumify is okay to occasionally use. It’s a redness reliever, so it can make your eyes look less red which could be nice if you’re out in public and don’t want your eyes to look too red; however, it’s purely cosmetic, it just masks the symptoms, and is something that shouldn’t be abused every day. But I have had patients on glaucoma drops use lumify once every few days and been happy. Talk to your doctor about it. But only Lumify; AVOID other redness relievers like visine

@madebyluv 3 года назад

Can an SLT be done even when on drops? I've heard its best on the virgin eye

@andreasoptometry 3 года назад

Yes. SLT will reduce your eye pressure by ~30%, which is comparable to using prostaglandin eye drops. If you’re ALREADY on eye drops, this reduction will be lower simply because your eye pressure is already being reduced by eye drops. The doctor will decide to either do the laser with the eye drops or without, depending on the situation. For example, someone who is on max therapy and still has a high Pressure will probably have it done with all the drops. But in the other hand, a patient could be told to stop their drops to see if the SLT would be enough to reduce the pressure without needing to use eye drops after. So it depends

@ilikesteak65 Год назад

unfortunately SLT does not work on everyone though. I had SLT in July and it didn't work for me. Now i take dorzolamide 2 % twice a day and latanoprost once a day.

@bpthegreatt 3 года назад

Question are they releasing a combigan about to have a generic

@andreasoptometry 3 года назад

Great question! I haven’t heard news on generic combigan, so I don’t think so. I would also be very careful if any online sources claim they’re selling generic combigan, as it could be a fraudulent medication or potentially harmful. Always only get medications from reputable pharmacies. I do hope a generic version gets approved, since combigan is pretty effective

@bpthegreatt 3 года назад

@@andreasoptometry the patent goes out April 2022

@andreasoptometry 3 года назад

Oh so hopefully by next year we’ll have a generic combigan then!

@sodecent8474 3 года назад

I was diagnosed with glaucoma when I was around six i’m 18 now I used xalatan for many years. I noticed in the video that you said it doesn’t work on children, but it worked great for me. Once I got older though it stoped working as well as it had so at first they switched me to vyzulta but it was to expensive. now I’m on Rocklatan but it makes my eyes so red and I feel like people think I’m stoned. do you have any suggestions?

@andreasoptometry 3 года назад

Hey thanks for the question! Interesting that xalatan worked on you as a kid and not as an adult! In medicine there are always exceptions to the rules! Yeah so Rocklatan is notorious for causing red eyes. One of my patients in the past started using Lumify like twice a day. It’s an over the counter “anti redness” eye drop. I typically don’t recommend anti redness drops too much (and especially NOT visine) but lumify hasn’t been shown to cause rebound redness in most patients. So you can try using lumify and see if it helps! The only thing I’ll say is do not use any eye drop 5mins within using another eye drop (for example if you use Rocklatan at 9pm, can’t use lumify until 9:05pm. Or you could use it at 8:55pm.

@meerabakshi2676 Год назад

My husband was told on his last eye check up visit that eye pressure is very high so stop LATANOPROST and use the ROCKLATAN drops were recommended. Since last 2 days my husband is asked to use ROCKLATAN instead. I was not with him and he does not remember if the doctor had told him about this new drops causing red eye. And today he was to go under surgery, we noticed red shot eye and the BP 183/88 I was alarmed. But the surgical staff nurse said, it might be the stress causing high BP. Luckily the Eye clinic is also in the same premises of the Hospital , so I went to that office and checked with the eye technician and she said, yes this drops may cause red eye, it is normal. Also he is given next month's appointment and if the eye pressure comes to normal, he may discontinue ROCKLATAN and switch back to LATANOPROST. Why ROCKLATAN causes red eyes? I would appreciate your educative response. Thanks.

@dm7232 4 месяца назад

Hi Doc, I’m really reluctant to use latanoprost because I do not want the pic me ration & loss of fat. Can I just go right to surgery?

@andreasoptometry 2 дня назад

Surgery should be a last resort because it can lead to many complications. SLT laser may be a better option

@memyprojectsc3678 3 года назад

Can any of these meds be used on dogs? My dog has developed glaucoma but the vet only gave me Neomycin ointment n Dorzolamide drops. I don’t see any change just look more irritated 😞

@andreasoptometry 3 года назад

Great question! I’m not a vet so I can’t definitely answer that, but if a dog’s aqueous humor (fluid in the eye) formation and drainage works the same as a human’s then I would imagine so. I would consult your vet (or another vet) but one thing to consider is that neomycin can be toxic to some people (that’s why sometimes neosporin can often cause a reaction/redness) so maybe the irritation is from that? Dorzolamide is a glaucoma drop.

@memyprojectsc3678 3 года назад

@@andreasoptometry thank you very much for your response 🙏🏼

@Liz-ny7dj 2 года назад

What are your thoughts on capsules to help with eye pressure?

@andreasoptometry 2 года назад

Good question! So first off, if by capsules you mean natural supplements like Mirtogenol, my research has found 1-2 studies that shows a decrease in eye pressure by 12%. That’s not great in my opinion because if you have mild glaucoma, a good starting point that you want is at least a decrease of 30% (is moderate then 40%, if severe then 50%). Even if you’re a glaucoma “suspect” and you start treatment prophyllactically, your doctor may want 20%. Now for actual glaucoma oral medications like Diamox, those definitely work they just have some side effects. Generally you want to rather use eye drops versus a pill because 1) the drug won’t travel to your body much so decreased side effects and 2) the drug will work better because it’s concentrated to the eye ball To put things into perspective, latanoprost eye drops you just use once a day and can decrease the eye pressure by 27-32%, sometimes even more!

@Liz-ny7dj 2 года назад

@@andreasoptometry okay thank you!

@nandoaikman4213 2 года назад

ia the glaucoma medications still effective if its frozen?

@andreasoptometry 2 года назад

People often put it in the fridge which is totally fine to keep it cold, but I would avoid freezing since if it solidifies it might affect the consistency of the drops. But that’s just my guess

@cathycharron-folsom4504 5 месяцев назад

I can’t take beta blockers. I got massive inflammation and blood clots. My glaucoma came in two years from chronic body inflammation and taking Eliquis caused actual severe optic nerve damage

@freespirit7450 2 года назад

Will lanaprost cause low eye pressure with people with normal eye pressure?

@andreasoptometry 2 года назад

Latanoprost, like all other glaucoma drops, will lower your eye pressure, regardless of if you start off with high eye pressure or normal eye pressure

@isaiahgibson3699 8 месяцев назад

Is blink eye drops good?

@andreasoptometry 8 месяцев назад

Blink eye drops are good lubricants but do nothing to reduce the eye pressure

@ahmadrehan2187 Год назад

I was on combigan but my doctor died now i went for a check up to another doctor and he prescribed me betaxolol HCL 0.25'/- Should i stick with these or go back to combigan?

@Anonymous-fm2xc Год назад

Ooof sorry to hear about your doctor dying. Did your doctor say why he made the switch? Combigan is an expensive drug that has two drugs in it. It is possible that you only needed one of the drugs based on the level of glaucoma, hence the switch to betaxolol? Every case is different, and so every doctor has to look at each case and make an individualized plan for each patient

@andreasoptometry Год назад

Sorry I responded from my old RU-vid account (anonymous is me)

@jean-lucdjukanovich4371 8 месяцев назад

👍

@yourstrulyEbby 3 года назад

Does Vyzulta cause dark circles? My doctor just switched me from Lumigan

@andreasoptometry 3 года назад

All the prostaglandins have the potential to cause dark circles (pigment deposition on the orbit). Vyzulta and Lumigan are both prostaglandins.

@yourstrulyEbby 3 года назад

@@andreasoptometry So it's basically no point of switching. I'm so very sad about this. I've been taking them for 2 months, and I have dark circles that make me look unwell.

@andreasoptometry 3 года назад

I wouldn’t say no point, if the dark bags are LESS than when you were on lumigan. Also vyzulta is way more effective as a medication, so the switch might be for the better. Idk if there were any other reasons for the doctor making the switch, so that is a conversation to have with him /her

@yourstrulyEbby 3 года назад

@@andreasoptometry I called my eye specialist to let them know about the darkening. I've also been taking Combigan for the last 2 months. Without having me come in to be seen, his nurse called back and said he would switch me from Lumigan to Vyzulta. He also related that dark circles usually happen after taking the medication over years. It's only been a couple of months for me. I'm so sad and fustrated.

@andreasoptometry 3 года назад

Sorry to hear about your frustrations :/. At the next eye appointment, you should speak with your doctor about possible alternatives to prostaglandin medications.

@hiitsmeemi 8 месяцев назад

Whats the difference between 2x a day and every 12 hours?

@andreasoptometry 8 месяцев назад

Every 12 hours is just more specific. So 9am + 9pm, or 10am+10pm. Twice a day is ideally spaced out one in the morning and one at night but doesn’t “have to be 12 hours” (so it could be 10am + 7pm) It depends on what the studies show how long the drug will last until you need to put another drop again. Probably not a big deal though, as long as the two drops are spaced out evenly. But ask your doctor about your specific med!

@hiitsmeemi 8 месяцев назад

@@andreasoptometry thank you for the info. I actually didnt know that.

@heidilady 8 месяцев назад

Timolol was a nightmare for me. Made my asthma AWFUL! Then my GP prescribed steroids for asthma, then steroids were causing IOP to spike….bad cycle.

@andreasoptometry 8 месяцев назад

Yeah Timolol is not indicated for people that have any lung issues like asthma :(

@letleah3265 3 года назад

I’m a Glaucuma patient. I use xalatan and alphagan. But still now I’m not ok. What shall I do?

@andreasoptometry 3 года назад

That’s something your eye doctor should answer. Could switch alphagan to combigan (more effective but WAY more expensive). But also if alphagan didn’t seem to be effective at ALL, the doctor may switch to something like timolol or dorzolamide, which are both different classes of drugs. So basically your question needs to be discussed at your next eye pressure check with your eye doctor

@letleah3265 3 года назад

@@andreasoptometry but the diagnose is ischemic optic neuropathy, bilateral.is there a chance to become ok doc? Thank you so much . God bless

@andreasoptometry 3 года назад

Ischemic optic neuropathy is different from glaucoma. If that’s what you have, that’s a condition that will likely not recover, but should also not get worse. Glaucoma is a different disease and is in a sense worse because it can progressively get worse. Again, great questions to ask your eye doctor.

@letleah3265 3 года назад

@@andreasoptometry thank you so much doc for the time u giving explanation to me. Coz my first doctor age said glaucuma. But my second doctor that I have now is not a glaucuma. But still I’m using alphagan drops. But as if now become slowly slowly I can see more than bfore. Thank you u so much. Have a great day.

@andreasoptometry 3 года назад

Got it. If you recently got the ischemic optic neuropathy, yes you likely may recover some of your vision. It won’t be back to 20/20 but you’ll recover some. Good to hear that vision is already getting better. After you’ve had it for a long time, it’s debatable whether you still need eye drops. For now though, continue using them and follow up with your doctor. Have a good day!

@alexanderbrocato2103 3 года назад

This doctor is pretty cute

@andreasoptometry 3 года назад

😳☺️ miss you buddy lol

@millyrodzreyes4102 2 года назад

Hello I have uveitis glaucoma I take eyes drops and my eyes is always cloudy why that happens?

@bigjohn418 7 месяцев назад

SLT isn’t bad. Just didn’t work well.

@andreasoptometry 6 месяцев назад

Unfortunately for some it has a great effect and for some it doesn’t :/

@Tocimah 9 месяцев назад

When will there be something for those who are unable to take pharmaceuticals?

@andreasoptometry 9 месяцев назад

Hey! Yes so there is something called “SLT laser” which is often recommended for patients that are uncompliant, on multiple eyedrops already, or can’t take eye drops. It recently become a primary treatment. The laser will “open up” the drainage area of the eye so that more eye pressure gets relieved. It’s pretty safe, noninvasive, it’s an in office procedure, and it’s effect can last many years (although average is ~2-5)

@Tocimah 9 месяцев назад

Yes, I've had it twice. I just had it, again, last month. I had it in 2018. Do you know anything about the Carnosine eye drops? @@andreasoptometry

@jasmynsglaucomajasmynpolit7033 3 года назад

An glaucoma medication can be expensive.

@andreasoptometry 3 года назад

That is true unfortunately. Luckily the most effective drug in most patients, latanoprost, can be found on good Rx for ~$12.

@sabirahamed3127 3 года назад

Hello, doctor! My mother is glaucoma patient so she can use this eye drops??

@andreasoptometry 3 года назад

Hi Sabir! Yes any of these drops are used for glaucoma but the specific eye drop may depend on the specific patient. So she should follow the recommendations of her eye doctor

@sabirahamed3127 3 года назад

@@andreasoptometry Yes, but the doctor asked me to give these piocarpain2%eye drop and betafree eye drop for the maintain the eye pressure, now NCT report RE-18 LE- 16 ,but my mother eye problem is Left eye, so in this situation which treatment are available?

@andreasoptometry 3 года назад

All these treatments are available (prostaglandins, carbonic anhydride inhibitors, beta blockers etc) but again it depends on the situation. Way more information is needed. But pilocarpine I would personally only use if the other eye drops are unsuccessful on her. For example, my favorite drop to try first is latanoprost. But your eye doctor may have tried that in the past. Ask your eye doctor for more information on what her other options are

@sadiaziro5109 2 года назад

@@andreasoptometry Please Doctor How Can I Get This Eye Drop For Glacoma Please Am Ghana, Thank You God Bless U

@andreasoptometry 2 года назад

Hello! You can get glaucoma eye drops from your local eye doctor, who will prescribe it to you if he/she feels that you have or are at risk of developing glaucoma

@INVISIBLESCORPION 5 месяцев назад

Drink cayenne pepper in water it’s healing to the eyes.

@andreasoptometry 5 месяцев назад

While that pepper has antioxidants and vitamins, there is no evidence that it “heals” the eyes. No signs of preventing glaucoma. The nutrients may be good to the body though like other nutrients from vegetables are

@OneCalvin 3 месяца назад

Bloody hell

@lolajohnson6057 9 месяцев назад

You needed to also inform patients of potential side effects. There are dangerous side effects that patients Must be told about in order for them to know before these drops are instilled in their eyes.😅 You didn't mention Lanoprost ! 😅 I've been this prescription. I looked it's side effects.... What I read of these effects are frightening!! I, surely, will NOT use this prescription. Unfortunately, for me, my family has a history of glaucoma. I saw this Ophth😢alomogist who did my 'Visual Fields.' When I we I went in

@lolajohnson6057 9 месяцев назад

My IOP were 14/16. After the various manipulations of new approaches to evaluating my eyes, IOP became hyperpremsis !! It's now 23/24 >l>r !! Lanoprost, in my view will improve my vision, but it will advance what I mostly dread ! In my opinion, non- compliance, is not only being forgetful. There are other reasons, such as mine. You, my friend, must always concider how you give a prescriptions, to your patients who are scared of losing their precious sights. Writing prescriptions is least of doing your job. Make it point not only to write the prescriptions. But be thoughtful to inform patients of the SIDE EFFECTS WHICH COULD BE LIFE THREATENING AS WELL AS LOSING THEIR SIGHTS FROM YOUR PRESCRIPTIONS!!!!😢

@lolajohnson6057 9 месяцев назад

Thank you.❤

@lolajohnson6057 9 месяцев назад

Pp Lanoprost will NOT improve my vision in my case. If I'm compliant with this prescription.

@andreasoptometry 9 месяцев назад

You mean latanoprost, which is a prostaglandin drug, which is the first drug class I mentioned. And yes I did talk about it’s side effects, redness of the eyes and more pigment. (Also increased eyelashes)

@andreasoptometry 9 месяцев назад

These drops are not meant to “improve vision”. They’re meant to reduce eye pressure and prevent glaucoma from making you blind.

@rjb7569 3 года назад

Doc... Slow it down a bit. Maybe lay off the caffeine before doing one of these vids. No time to absorb what you're saying, or jot down a note or two. I'm aware, as a glaucoma patient of 30+ years, of a lot of this, but you're racing through this, and I'm sure, leaving most viewers in the rearview mirror.

@andreasoptometry 3 года назад

Thanks for the feedback! I can’t please everyone 🤷🏻‍♂️ if I slowed it down this would be like 25-30mins, which would be too slow for other doctors watching this. You certainly are able to slow down the playback speed to x0.75 or x0.50 so it’s closer to your ideal speed. I also don’t drink coffee so I can’t imagine how much faster this would be if I did 🤣.

@rjb7569 3 года назад

@@andreasoptometry Shouldn't other ophthalmologists already be aware of these medications? If they're not, they are doing their patients an injustice. As a patient advocate for my parents when they were alive, I was somewhat astonished by the lack of common knowledge some of their doctors failed to be aware of. Thanks for the response, though. I thought of the slowdown procedure after posting and have utilized it to add to my notes.

@andreasoptometry 3 года назад

Yes that is right, but the point of the video is how to BEST optimize pressure lowering effectiveness with the LEAST number of drops possible to ensure compliance. It is a skill that can be tricky to learn and one that I developed during residency. So while many optometrists and ophthalmologists (who may not have specialized in glaucoma) want to start managing more glaucoma patients, they may approach it in an inefficient manner (for example adding another drop after having just one bad eye pressure reading) . This video wishes to help those people out, especially since some of my audience are student doctors who haven’t graduated yet :). But yes thank you for the comment and I’m happy that you are finding this helpful enough to take notes.

@patriciakinloch9896 3 года назад

You talk much too fast and don't pronounce words clearly. I find that so difficult to listen to.

@andreasoptometry 3 года назад

Hi Patricia! I’m sorry if my speed seems too fast for you. My intentions were to make this video not too long. But, to help you out, I would advise changing the settings on the video to slow it down to x0.5 or x0.75 speed. That will actually slow down my voice so you can understand me better. Hope that helps!