SLT FOR GLAUCOMA AND BLEPHARITIS

Thank you for your reply.  Of course you are right and those with uncomplicated treatment are not likely to go on line and talk about it. 

It is because I have suffered from blepharitis for many years with good and bad times which did affect both cataract surgery after effects one much more so than the other I am naturally concerned about the forthcoming laser treatment.  Blepharitis is a lifelong problem for many people and we all have daily regimes which we could do without to keep this condition under control.  The reason for the eye hospital suggesting laser treatment is because the eye drops which you probably know can cause side effects are often increased by any existing blepharitis.  If the laser does not work I will have to have eyedrops.  I have tried 2 different eye drops and they did make my eyes worse.  Maybe it will be something I will have to live with if necessary but blepharitis sufferers will know how much this condition can affect your daily life.  I really wanted to know if there was anyone on the forum in the same situation as me and could advise.  Of course I will speak to the opthalmologist on the day as I did with the cataract surgeries and see what they say.  Hopefully it will be the doctor who did the 2nd cataract operation as I know he does laser treatment and he will know if I should go ahead or try the drops again.  

Best wishes

indeed, blepharitis is unpleasant to say the least....i use 2 types of eye drops daily, and also sometimes salt water eye baths (but please don't try that before speaking to your opthalmologist).

i've heard that sometimes it is the preservative in the eye drops that can exacerbate blepharitis and some people have found reduced side effects by using different drops.

wishing you all the best with your operation. 

let us know how you get on!

 

Hello Thank you for your kind words of encouragement.  

I have salt water baths and preservative free glaucoma drops already on my list of questions for the opthalmologist.  I use the single dose P F celluvisc as a lubricant actually prescribed by Moorfields not only for the bleph and dry eyes but to help lubricate the eye before using Xalatan when I was first diagnosed with early stage glaucoma in 2011.  These drops did affect my eyes if I remember but the main thing was they made my asthma worst and I was walking around with a very tight chest and breathing was hard so I was taken off them.  The decided at the time not to give me anything else and to wait until both cataract ops were done.

They were done in Nov 2012 and Jan 2014.  The large gap between the 2 surgeries was because although I had the first one done in London they decided to start doing cataracts at the Moorfields outreach centre at my local hospital and it kept getting delayed so I was in limbo. If I had known how long I would have to wait I would have asked to go back up to London even though it was much further away and being in the City parking is awful and expensive and then there is congestion charge. I

decided at the time to keep to my local hospital (5 mins drive away) as being an arthritis sufferer I was in a lot of pain at this particular time. During this time at my clinic appointments at the local Moorfields they did speak about lasering after the cataracts were done.  They have been pondering since Jan 2014 as to whether to just keep an eye on me or try drops again or lasering.  I also had azopt after the 2nd cataract op because the pressure went up due to the steroid eye drops you have to take for 6 weeks afterwards.  It is hard to know what they would have been like long term.  I am torn between trying eyedrops again and having the laser.  It does not help that I suffer from anxiety which I had got under control but I can feel it creeping back again.  I had councilling which really helped me.  I am trying not to get stressed as I don't want to feel like I did last year.  I feel I have enough to cope with eyes, IBS, Arthritis,

etc.  If I have any more pills I will rattle.  I looked forward to retirement but 

I can't do all the things I would like.  I am hoping things will improve healthwise for both me and my husband.  Sorry to have moaned on a bit.

I do get carried away.  

I will let you know how I get on

Thanks again.

 

Hello,  Just an update on my situation.  I had the SLT (laser) on my left eye last Monday.  Went well actual lasering only took about 5 mins.  No pain during procedure but the lens thing they doctor holds over your eye was a bit uncomfortable.  I think this is possibly because I have sensitive eyes from the blepharitis.  My eye was mildly irritated that night and very slightly red for a couple of days once again I think due to having sensitive eyes, no pain at all.  I was given anti inflammatory drops to use but only if my eye was painful so I did not have to use them.  I go back on 1st June for check up but of course will not know for a few weeks if it has worked and lowered the pressure.  My readings on the day before the laser were 23 left and 22 right.  It did go up slightly after the laser and I was given glaucoma drops to bring it down.  I believe a spike sometimes happens after this treatment.  The only other thing was I had a headache from the drops but I took paracetamol whilst waiting and it went quickly.  I hope all this will be of some help  to anyone undergoing SLT and feeling nervous about it.  I suffer from anxiety and I can say that it was quick and virtually painless.  If they recommend the right eye be done (assuming the left one works) then I will not hesitate.  There was early glaucoma in the left eye but my right eye is fine just higher pressure.  Will have to wait and see.  Teeth next need a crown doing. Hope every one is well.

 

well, it all sounds promising so far.

hope that continues

best wishes

 Hi  I have been back to the eye hospital for a check on the lasered eye.

Everything is ok pressure has not changed as yet (22) although it did rise after the laser so it has come back to what it was.  I understand it takes upto 8 weeks to find out if it has worked.  I have to go back in August to see if it has worked earliest appointment I could get.  Fingers crossed.

indeed. fingers crossed. sounds positive so far!

Hi all,  I have just come back from Moorfields clinic.  It is 12 weeks since I had my left eye lasered.  Unfortunately it has not worked the op before the laser treatment was 23 and today when the nurse did it it was the same although the doctor took readings of 20 in both eyes.  It was suggested that I have shunts put in although they may not work.  At the moment having had 2 cataract surgeries and the laser I do not want any more surgery.  The consultant said it is just my left eye which if of concern.  He just wants it at a slighly lower safer  level.  So reluctantly I have agreed to go back on drops AZOPT but I will probably get side effects like before.  The other possibility is Xalatan preservative free but I decided against this as last time it gave me a tight chest (I have asthma) and as they only want to treat one eye I was worried about the eye colour change.  I have to go back end of November but can contact them if I have any problems with the Azopt.  Any one out there use Azopt or Xalatan preservative free I would love to know how you get on with them.

I has SLT today...should I continue tonight with my eye drops...Azopt and Ganfort as normal in both eyes....

Hello I had to read through my posts again and they are over 4 years old. They should have told you whether to continue with your eye drops after the SLT. In my case I was not taking eye drops prior to the laster treatment it was done in the hope to avoid eyedrops as I was sensitive to them. Unfortunately it did not bring the pressure down in the eye at least not enough so I have been on Azopt since then just in the left eye and stable, right eye still ok. No problems with Azopt still have blepharitis and use preservative free artificial eye drops. Have moved now to different part of UK and eye clinic was already running behind in routine appointments now with Corona virus it is even longer hope appointments will resume soon if possible as it is nearly a year since my last checkup. My husband is shielding from corona virus so don't really want to go out unless necessary.

Hi,  My husband put the first drop in for me but I must learn to do it myself I manage ok with lubricant drops.  I know what you mean about being hard to get a drop out but it says just pressing the base should do it not squeezing the bottle but you probably already do that.  I was on azopt for one month after cataract surgery as the pressure when up because of the steroid drops I was taking.  I will persevere but if the side effects are too bad I will ask to try the preservative free Xalatan.

Hope you continue to do ok with Azopt.

Hi I have been using Azopt for 6 days.  As you say it is a bit tricky sometimes to get the drop to fall out good job it is white rather than clear so you can see it clearly.  Like you not much in the way of side effects and they do not seem to affect my blepharitis.  I was told to put my finger over the corner of the eye for about 30seconds to avoid it going into the nose etc.  On advice of someone else I read about some time ago I have been doing that for around 3 minutes also taking a cotton wool pad and wiping around the eye and eyelashes to remove any excess.  Not sure if I am being a bit over the top but is seems to be working.  Of  course I don't know if side effects occur soon after starting the drops of after sometime.  I did have the tablet form of this drug after my cataract  surgery and they gave me the most awful finger tingling, unbearable but I only had to take them for 4 days.  I don't think this is a side effect of the eyedrop version.  I have noticed some mild itching and tingling at times but I don't want to blame it on the Azopt as I have various other problems and do have various odd symptoms from time to time.  It would be good to hear from other Azopt users to hear how they have got on.  Hope you are still finding Azopt side effect free.

Same here, it's an art getting the drops out of the bottle. I get either nothing or a big splodge.

I have to use both Azopt and Travatan, I don't really get any side effects from either, only the lashes growing from Travatan, but to me that was a good side effect. 

I use a blue eyecup that fits around the neck of the bottle, it makes it much easier to administer the drops yourself. I don't have anyone to do it for me anyway. Sorry I can't remember where I got the eyecup from it's been a few years ago and it was only £2/3. Maybe you could Google it. Best of luck.

Thank you I will check up on the eyecup but am finding it easier now.  I only have to do the left eye and being right handed it is harder than the right.

Hi I have not had any luck in locating the blue eyecup you talk about.  On line there seems to be something which holds the bottle for those with arthritis hand etc.  I don't think this is what you mean.  I still wonder if the drop coming out is ok.  It does look quite large and takes a little time to fall into the eye.  I use Azopt twice a day one eye only.  How long should a 5ml bottle last?  I am just concerned about overdosing.  Sometimes at night my husband does the drop for me and it seems fine as I can lay down for him to instill the drop.  Any thoughts please.

i'm eventually getting the hang of pressing the base of the bottle to get the drop out. it does take patience sometimes waiting for the drop to fall doesn't it? i lie down and hold a mirror up and to the side so i can see what i am doing. it looks large since it is white and somehow seems to  cover quite a large area when it lands, but i assume that it is the right amount....

anyhow i am due to see the opthalmologist tomorrow so i guess if i have been over or under dosing they might be able to tell? who knows...

re how long does a 5ml bottle last, i use it twice a day in both eyes and the bottle has lasted a month.

good luck!

Thanks for the reassurance on saying that since the drop is white it looks large compared to my clear lubricant drops.  I tried just tilting my head back, pulling out lower eyelid and supporting the hand but I missed and twice it landed on my cheek so have gone back to looking into mirror.  As you say you will find out soon if you have been getting the right dose.

Yes I was told the bottle should last one month for both eyes twice a day,

so I should have half a bottle left as I only do one eye.  I don't see the opthalmologist until November.  I was told to get in touch if I have any problems.  Do let me know how you get on at the clinic.

 

hi just back from opthalmologist and she was very satisfied with pressures.

also said that the azopt is twice a day and not necessarily 'every 12 hours', which is a relief. 

good luck

That's good news that your pressures are being controlled.  I do take them 12 hours apart usually 9am and 9pm and I did wonder about going out for the evening (seldom do these days) and it is good to know that maybe I could take it later in the evening is that how you understood it?

Hi, have you considered Ganfort UniDose? No preservatives and for me it works great after agony with Xalatan. I had chronic inflammation with that. 

hi yes that is how i use it: on waking and just before going to bed and i am awake more than i am asleep. also the hours change, especially weekend cf weekday. 

i assume that i'm doing the right thing!

Hello  Yes I assume too that I am doing the right thing.  You can't always be exact on the timings at least I have never forgotten to put them in.

I will check next month when I go back to the eye clinic about timings especially as I am going to a big birthday party soon and I will either have to take the drops before I leave or when I come back.  You do have to have a life don't you.  

Sorry I have not replied sooner.  Have had some family health issues on my mind.  I have just looked up Ganfort Unidose on line and I can see it contains Timidol which I believe is a beta blocker and I can't have this type of drop because I suffer from Asthma.  Thanks though for thinking of me and suggesting it.  I am doing quite well on the Azopt really only minimal side effects slight sore eye at times but nothing much could also be just my blepharitis.  When I go to the eye clinic next month I will know if it is bringing the pressure down in the eye.  I also have been told I could try Xalatan preservative free if needed although the ordinary Xalatan did make me tighted chested which is why they decided to stop it way back in 2010/11? and just to monitor me.  Obviously this year after having both cataracts done 2012/2014 they decided to try laser in the left eye but it did not bring it down much hence the Azopt.  The right eye they said does not need treating as yet as there are no changes.  I think Azopt is gentler than Xalatan.  Hope you have continued success with Ganfort Unidose.

Hi just wondered how you are doing on Azopt and it is now a while since both of us started on it.  I have had minimal eye problems which I was surprised about even though I suffer from blepharitis.  I have been using them left eye only since 10th August.  On advice of someone can't remember who I have been doing puntual occlusion (think that is what you call it) finger over corner of eye for 3 minutes to help stop drug going into blood stream and to hence avoid or decrease side effects.  The clinic doctor said 30 seconds was enough but to be on the same side I have continued with 3 minutes.  Everything seemed to be fine but in the last couple of weeks I have noticed I am getting tight chested (I have mild asthma) and sometimes a bit dizzy when laying down at night.  I know these are both know side effects of Azopt.  I am due back at eye hospital in 5 weeks to see if pressures have gone down and drops are working.  I am loathe to try the other only alternative I was offered Xalatan preservative free.  I have had Xalatan before not pf and this really caused tight chest all the time so was taken off them.  I can try the Xalatan pf but as I am only using drops in one eye I don't really want to end up with different colour eyes.  I am trying to tell myself that it is just my anxiety causing these symptoms.

I have had my husband in hospital twice end of August then a  week later with breathing problems and looks like he has COPD and is now on 3 different inhalers.  No appointment for him for diagnosis until Dec 17th really annoyed about this should have been this month but I think A and E did not refer him back to consultants.  So worried about him

also my son had a minor stroke last month as well thankfully he is recovering well and back at work part time.  He does not see a consultant until January.  I know it is like this with waiting times but it does make you feel like no one care.  Going back to Azopt just wondered if you or anyone else reading this had any problems.  They say you get a bitter taste in the mouth but I have not noticed it perhaps because of the 3 min thing.