Glaucoma

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I was diagnosed early dry AMD and early Glaucoma about 1.5 yrs  back. My eye sight was reasonable when diagnosed and it is quite alright even now. I have been using Glaucoma eye dropsTravatan once a day and Azopt twice a day for the last about 10 months. Recently I felt slight nasal congestion. Though there were no other major asthmasymptoms, I got suspicious that it may be start of asthma problem as contained in side effects of above eye drops. I consulted the chest specialist who examined me, did a test with Peak Flow meter which was OK. Yet he prescribed use of Nasal sprays and inhalers so that nasal congestion gets cleared if at all there. After reading brochures of these sprays/inhalers, I noticed that such sprays/inhalers can raise eye pressures, hence patients of Glaucoma have to be very cautious about it. Hence I have not used them so far.

Can I have the views/experience of those who have been confronted with such a situation?

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  • Posted

    Hello,  I too have glaucoma and use azopt in left eye, right eye is ok and is being kept an eye on.  I also have asthma and use inhalers.  Last year I started using antihistamines and a  steroid nasal inhaler.  I can't remember the name but this it might have began with F.  I had been previously been diagnosed with perrenial rhinitis, symptoms nasal congestion,sneezing etc.  Although they worked well when I went for my glaucoma check it was found that my pressures in both eyes had gone up to 26.  Previously they had been stable at 18 left eye and 20 right. The doctor said they would see me in  6 weeks and if they had not gone down, they might need to change/increase my treatments. When I got home I did some online reseach and found that these inhalers and antihistamines had the potential to raise eye pressure and was well known to opthalmologists.  Athough I assume not all glaucoma patients would be affected, I was told when taking routine  steroid eyes after cataract surgery that I was what they call a steroid responder as my pressures increased.  With the consent of my gp I discontinued the nasal steroid spray and antihistamines and when I returned to the opthalmologist my pressure in both eyes had gone down to 18 and 20 as before.  Whilst of course I can't 100% say this was the cause I am pretty sure it was.  I don't think asthma inhalers are as bad although all steroids have the potential to raise pressures and glaucoma, but steroid nasal sprays and eye drops yes I think if you are that way inclined then there could be a problem.  I tend to think generally the medical profession play down side effects until to complain about them.  Hope this helps.

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    • Posted

      Thanks for your detailed response. I went to two specialists; ENT and Chest. ENT specialist suggested an ordinary Nasal Spray Flunisolide 0.025% which contains steroid, similarly Chest Specialist suggested nasal spray Rinoclenil 100  (beclomethasone diproplonate) and Saltra inhaler (Salmeterol+Fluticasone Propionate) which also contain steroids. I feel there is no nasal spray or inhaler which is steroid free. All these contain steroids. I have yet not started as I am still doubtful if at all I have early asthma or not; no sneezing, no hard coughing etc.

      By the way, were you having asthma before starting Azopt or after that?

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    • Posted

      Hello again, I have been thinking back and I can tell you that my asthma was diagnosed following a bad cold Christmas 2001.  I was prescribed inhalers in January 2002 so before Azopt.   I know this is correct because my son married on New years Eve 2001 and I was having trouble with chest tightness.My asthma has been mild since then.  Around 1998/99 I attended  Moorfields (lived in Greater London then) and was diagnosed with ocular hypertension but no damage to eyes.  I attended the hospital until 2005 as I was not getting any worse and they thought I was at lower risk of Glaucoma.  All was well until around 2010.  At this time I also started to get worsening blepharitis and after visiting my optician for eye check I was once more referred back to hospital for eye pressure, changes to optic disc,blepharitis and cataracts.  Incidentally in 2005 after routine eye test the optician did see  a slight scattering of cataracts in one eye.  It took a few years before I got any symptoms.  I had cataract surgery in 2012 left eye and 2014 right eye.  I understand that the type of cataract I had were subcapsular posterior type.  These can be caused by steroids, Diabetes etc and I think they progress quicker than the common type.  However I was in my sixities at the time so not unusual to get cataracts.  I am now 69.    Before the cataracts were done in 2011 I was tried on Xalatan for the left eye as it was showing early changes but I had to come off it as I had breathing problems. It was decided just to monitor the eye pressure and after the cataracts were done my pressures lowered a bit which I understand does sometimes happen after this surgery.  They then decided just to monitor the eye pressures and take regular photos of back of the eyes.  In 2015 I underwent laser treatment on the left eye to try and lower the pressure but it did not really work or at least not well enough.  I then started on Azopt twice a day just on left eye.  The right eye still not needing treatment.  I hope this helps you.  It is hard to say whether my asthma inhalers caused the changes in the left eye and cataracts but it is possible however the right eye as mentioned is still ok.  My eye pressures are usually 18 left and 20 right.  I since moved up to the North of England and am under the care of the opthalmolgy  Department at our local hospital.  I am lucky in that I have had no problems using Azopt and I know that many eye drops can cause sore red eyes etc.  Knowing that I might have needed different or additonal eye drops if my pressures did not come down was the main reason for coming off the nasal spray and antihistamines.  I now manage just with salt water spray.  Touch wood not too bad so far this year.  Whether it is right or wrong after instilling the Azopt drop I put my finger over corner of eye for 2/3 mins which was something I was advised.  I also take a small cotton swab and clean my eye lashes as well and as I mentioned have not had any problems.  Fingers crossed it will remain this way.  Hope this helps.  By the way asthma does not cause sneezing I don't think.  It usually causes shortness of breath,tight chest and coughing especially at night.  Rhinitis and other allergies cause sneezing and congestion.  It is not uncommon to have both and each can make the other worse.  Good luck hope you can sort out whether you do have asthma or not.

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    • Posted

      Sorry also meant to say that I think the steroid nasal spray I had was fluticasone the one you have been prescribed.
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