Monday Night Chat Highlights
June 11, 2001

Norma Devine, Editor

Dr. Jeff Henderer, a glaucoma specialist at Wills, paid another visit to the Monday night chat room.

Dr. Jeff Henderer:  Hi all!  I have a few minutes, so thought I'd stop by.

Host:  We are delighted you came.   

P:   My left eye tears in the morning.  I had cataract surgery on March 29th.  What causes the tears?

Dr. Jeff Henderer:  That's a tough one.  Could be toxicity from eye drops or it could be irritation from toxins in the tear film.  Usually, I tell patients to rinse their eyes and if that doesn't help, then an artificial tear ointment at night.

P:  Rinse the eyes before bedtime, Dr. Jeff?

Dr. Jeff Henderer:  Maybe a loose stitch from surgery is causing the tears.  Usually sutures feel like sand and bother people all day.  Rinse your eyes in the morning to wash away any toxins in the tears that have accumulated overnight, and use an artificial tear. 

P:  I get a tear or two in the morning from the eye that most recently (April 10) had a trabeculectomy, but I think that wearing an eye shield might cause the tears.  

Dr. Jeff Henderer:  That might be.  

P:  I was recently told that I have pre-glaucoma.  The people here in the chat room recommended that I see a specialist, so I made an appointment with one.  I don't understand why my right eye sometimes burns as if I've peeled an onion.  

Dr. Jeff Henderer:  I'm glad that you are headed to see a specialist.  I'm not sure what you mean by burning?

P:  When I took my last visual field test, my eyes watered through the whole test and the burning sensation took a while afterwards to clear up.

Dr. Jeff Henderer:  That is a common problem.  Sounds like you might have some dry eye. Like me.  The symptoms come on when you concentrate a lot, such as watching television, driving, reading, visual-field testing.  The trick is lubrication.  Using artificial tears before and after the test and other activity should help a lot.  Make sure you use only tears, not something to "get the red out." That stuff causes allergies in most people and is no good.

P:  You can blink often during the visual field test, too, right?  

Dr. Jeff Henderer:  Yes, you can. But look straight ahead!

P:  The pollen count around here is brutal.  My eyes are red, and it is painful around them.  Can pollen in the air cause any damage to my eyes?

Dr. Jeff Henderer:  As far as I know, no.

P:  Is GenTeal the best artificial tears to use?

Dr. Jeff Henderer:  GenTeal is very good.  Bion Tears is similar.  Refresh is another common brand.  So is Tears Naturale, Tears II, and the like.  You can find them in the drug store with the contact lens products. 

P:  Can you use artificial tears as often as you want to?

Dr. Jeff Henderer:  Yes, but some people get a toxic reaction to the preservative if they use tears many times a day.   For such people, preservative-free drops are the best.

P:  When someone is diagnosed as pre-glaucoma, how long, in general, will it be before the diagnosis becomes glaucoma, and is there any way to tell which kind of glaucoma it will be?

Dr. Jeff Henderer:  The answer to that would win a Nobel Prize!  I just don't know how to predict that.  Constant examinations over time will, we hope, catch anything before it is too serious.

P:  Does pre-glaucoma mean the same thing as ocular hypertensive and glaucoma suspect?

Dr. Jeff Henderer:  I think so. The term really has no scientific meaning that I am aware of, but is probably used in the descriptive sense to mean "suspected of having glaucoma."

P:  I had a trab in November.  Now it seems I have developed a cataract.  How long should one wait to have a cataract removed?

Dr. Jeff Henderer:  Great question.  It's common to have a cataract develop after a trabeculectomy.  If the cataract bothers your vision, then you may have to consider having it out.

P:  Then what? 

Dr. Jeff Henderer:  I assume you mean if the cataract surgery causes the trabeculectomy to fail?  That would depend upon the amount of pressure rise, the amount of damage and the options for drops, laser, etc.

P:  Can having cataract surgery hurt a trabeculectomy? 

Dr. Jeff Henderer: Yes, it can..

P:  I've had laser surgery, been through all the drops and have a good size blind spot.  

I've also had laser twice in that one eye for a torn retina.  I will have a visual field test tomorrow and am nervous about it.  

Dr. Jeff Henderer:  That is a lot.  But if you can't see, then you can't see.

P:  In my case, after my first two trabeculectomies, the cataracts got so bad I had no option but to have them removed.  

P:  Do most glaucoma specialists perform cataract surgery and trabeculectomies at the same time?

Dr. Jeff Henderer:  No.  The situation is different for each person.

Dr. Jeff Henderer:  See you all later. Have a great week.  Good night. 

P:  Thank you very much, Dr. Jeff.  It's good of you to answer our questions, even if we don't like some of the answers.

Host:  We hope you will stop by again soon.   Good night. 

End of chat highlights for June 11, 2001.

On June 13, Dr. Wilson discussed "Living with Glaucoma" in the Chat room. Click here for highlights of that meeting.

Click here for the most recent glaucoma chat highlights and links to the chat archives.

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