All posts by Dr Hussain Patel

Recent research highlights 2017

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Antihypertensive Medication Postpones the Onset of Glaucoma

Hypertension, March 2017, Volume 69, Issue 3

This large population based study identified that patients treated with antihypertensive medication had a lower risk of developing glaucoma compared with individuals not on this treatment. This effect was seen with all forms of antihypertensive medication. Hence, although hypertension itself is associated with glaucoma, the use of antihypertensive medication appears to be protective against developing glaucoma.

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Treating Glaucoma – how low does your eye pressure need to be?

Having a high eye pressure (also called intraocular pressure or IOP) is one of the main risk factors for the most common type of glaucoma – Primary Open Angle Glaucoma (POAG). An eye pressure of above 21 mmHg is generally considered to be above the normal (the normal range is 10 to 21 mmHg). If you have a high eye pressure and changes to your optic nerve (the nerve that connects your eye to the part of the brain responsible for vision) and corresponding loss of your side vision (termed peripheral vision) you will likely be diagnosed with POAG.

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Glaucoma medical therapy

The goal of therapy is stop patients from being affected by vision loss due to the glaucoma. Unfortunately most people with glaucoma are unaware they have it as it starts by affecting the side vision and then gradually works it’s way inwards to affect central vision. Our aim is to prevent this from happening and the only way this can be achieved is by lowering a patient’s eye pressure, using the safest way possible.

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Unilateral Glaucoma

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Introduction

Unilateral glaucoma is a common presentation that is often associated with very high IOP and rapidly progressive disease with a high risk of loss of vision in the affected eye. The majority of patients will have a secondary form of glaucoma and it is essential to identify the underlying diagnosis as management often involves both addressing this underlying cause as well dealing with the raised IOP.1

The differential diagnosis is broad with a list of common causes presented in Table 1.1 Although the emphasis here is on conditions that most typically cause unilateral glaucoma, bilateral glaucoma can sometimes present unilaterally hence needs to be considered in your differential. Continue reading

Glaucoma and Driving

For many people driving is an essential part of their daily life and not being able to drive can have a significant affect on their quality of life. When it comes to deciding whether a person has satisfactory vision for driving there are two aspects to consider. The first is central vision, which is the vision you use for looking at objects straight ahead. The second is your peripheral or side vision that you use to see objects in your wider field of view. Continue reading

Are you at risk of getting glaucoma?

The simple answer to this question is yes – anyone can develop glaucoma. However there are certain risk factors that you may have which increase your risk of developing this disease. It is important to know if you do have these risk factors so that you can be more closely monitored. Unfortunately for the most part glaucoma does not have any symptoms until it is often too late – so regular monitoring by an optometrist or eye specialist is the only way the disease can be diagnosed early and vision loss prevented. We estimate that nearly half of all people with glaucoma in New Zealand are still to be diagnosed. Continue reading

Uses and Abuses of Diamox

Figure 1: Patient with acute angle closure
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Introduction
Diamox (acetazolamide) is a systemically administered carbonic anhydrase inhibitor (CAI). Although there are several clinical indications for Diamox, its usage is limited due to many side effects, contraindications and drug interactions. Often the adverse effects are mild and self-limiting but sometimes they are severe and life-threatening. Caution is therefore needed when considering treating a patient with Diamox. Continue reading