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cellioI saw my opthamologist for my regular checkup today and was surprised to learn that medicine's understanding of glaucoma has changed since it was last explained to me. I guess I think of glaucoma as an old, well-understood disease that doesn't change much.
For the first time ever, while my eyes were numb anyway they applied a second gadget. After the round of "heywaitaminute, tell me what you're doing before you do it", I learned that this gadget measures the thickness of the cornea. (The technician doing it didn't know the mechanism and I haven't gone looking yet. I wonder if it's sound-based; how else would you measure the thickness of something like that?) She noted that my corneas are thicker than normal but would not pronounce that good or bad.
My opthamologist pronounced it good. Well, not good in absolute terms, but it turns out that people with thicker corneas tend to measure higher for eye pressure, which is what the glaucoma test measures. So my pressure might not be as high as they think it is. Hey, I said, my pressure has always been borderline anyway; is high pressure the sole detector for this disease and do I really have it?
She said that contrary to what I was told when I got the diagnosis (and several times since), high pressure isn't the definition of glaucoma. That's just high pressure. Glaucoma is a condition of the optic nerve usually caused by high pressure, though there exist people who have low pressure and the optic-nerve condition (and people with high pressure without effects). I do have damage to my optic nerve, though she hasn't noted it getting worse (which is both good and expected).
I should have asked her to describe what the medicines I take do, just to satisfy my own curiosity. (And, well, my co-pays just went up again...) My impression is that one is about lowering the amount of ocular fluid produced and another is about venting it, and I'm not sure what the third is. Oh well; I can ask next time. She said that she is not going to change the treatment at this time based on the cornea thing because that's speculative, which sounds right to me. There's plenty of time to ask later if I'm actually taking the right mix of drugs; it sounds like, at worst, I'm taking something ineffective. I'd rather not waste money on something known to be useless, but when in doubt, my eyes are a heck of a lot more important than saving some money.
She also suggested that it may be time to get pictures of my optic nerves taken. I gather that the philosophy is similar to that of the mammogram: at a certain point you start looking and from there on you're looking for changes. She described the process for the eyes as "sort of like a CAT scan but without radiation", which doesn't tell me directly (I don't know from CAT scans) but I can apply Google. She said it can wait until summer, when I'm next due for a visual-field test, and they can do 'em together. Ok, whatever.
I'll be interested to compare notes with my father, from whom I inherited the glaucoma, to see what his doctor has been doing lately.
Tidbit picked up in passing: my opthamologist has been practicing for 13 years. I've been seeing her for about 8; I hadn't realized she was so new when I started going to her. When choosing a doctor there's an interesting trade-off between recency (more up-to-date education) and decades of experience (seen more "in the wild"); I'm pretty happy with her, though I got her semi-randomly so that's just luck.
For the first time ever, while my eyes were numb anyway they applied a second gadget. After the round of "heywaitaminute, tell me what you're doing before you do it", I learned that this gadget measures the thickness of the cornea. (The technician doing it didn't know the mechanism and I haven't gone looking yet. I wonder if it's sound-based; how else would you measure the thickness of something like that?) She noted that my corneas are thicker than normal but would not pronounce that good or bad.
My opthamologist pronounced it good. Well, not good in absolute terms, but it turns out that people with thicker corneas tend to measure higher for eye pressure, which is what the glaucoma test measures. So my pressure might not be as high as they think it is. Hey, I said, my pressure has always been borderline anyway; is high pressure the sole detector for this disease and do I really have it?
She said that contrary to what I was told when I got the diagnosis (and several times since), high pressure isn't the definition of glaucoma. That's just high pressure. Glaucoma is a condition of the optic nerve usually caused by high pressure, though there exist people who have low pressure and the optic-nerve condition (and people with high pressure without effects). I do have damage to my optic nerve, though she hasn't noted it getting worse (which is both good and expected).
I should have asked her to describe what the medicines I take do, just to satisfy my own curiosity. (And, well, my co-pays just went up again...) My impression is that one is about lowering the amount of ocular fluid produced and another is about venting it, and I'm not sure what the third is. Oh well; I can ask next time. She said that she is not going to change the treatment at this time based on the cornea thing because that's speculative, which sounds right to me. There's plenty of time to ask later if I'm actually taking the right mix of drugs; it sounds like, at worst, I'm taking something ineffective. I'd rather not waste money on something known to be useless, but when in doubt, my eyes are a heck of a lot more important than saving some money.
She also suggested that it may be time to get pictures of my optic nerves taken. I gather that the philosophy is similar to that of the mammogram: at a certain point you start looking and from there on you're looking for changes. She described the process for the eyes as "sort of like a CAT scan but without radiation", which doesn't tell me directly (I don't know from CAT scans) but I can apply Google. She said it can wait until summer, when I'm next due for a visual-field test, and they can do 'em together. Ok, whatever.
I'll be interested to compare notes with my father, from whom I inherited the glaucoma, to see what his doctor has been doing lately.
Tidbit picked up in passing: my opthamologist has been practicing for 13 years. I've been seeing her for about 8; I hadn't realized she was so new when I started going to her. When choosing a doctor there's an interesting trade-off between recency (more up-to-date education) and decades of experience (seen more "in the wild"); I'm pretty happy with her, though I got her semi-randomly so that's just luck.
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Date: 2006-01-04 07:50 pm (UTC)(Do this at home, not at work; there's sound, and you really need to hear the sound to appreciate the site.)
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Date: 2006-01-05 02:16 am (UTC)(no subject)
Date: 2006-01-05 04:44 am (UTC)(stuff on my cat is still the best...)