Closed Angle Glaucoma Help

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Dh has just been diagnosed with this and we need to know more about it. Can anyone help please? It seems worrying and he's been given a booklet by the RNIB which really hasn't helped!

I was picked up at high risk of this at a routine optician appointment. I was referred to the hospital who confirmed it. They said they could make a small hole in my iris with a laser on the NHS or I could go private and have lens replacement. Both procedures would solve the issue but the lens replacement would also mean I wouldn’t have to wear glasses any more. I opted for the latter. I have 20:20 vision now and no risk of angle closure glaucoma. My eyes are a bit dry and I use drops to counter this but it was definitely worth it.

Thank you, the consultant did mention surgery but didn't go into detail or dh just can't remember. He's already had the lasers and it hasn't resolved it. He's just left now thinking he's going to go blind. How much was your surgery?

Maybe your DH is a bit squeamish - like me. In the end I had laser surgery and I was petrified and didn't want to think about it. It was OK and nothing really to worry about. However, it wasn't successful and I've had to use drops every night for years now.

Has yours progressed? Do the drops have side effects? He's had the laser surgery, but there is a proper surgery which is what the pp was describing.

Does having it affect you? Has it affected your mental health?

The laser surgery affected me as I could see lines and patterns particularly when it was very light and sunny so really didn't like that at all. This lasted several years! The drops - Monopost help to reduce the pressure and my eyes have been stable at my yearly checkups. I honestly can't say it's affected my mental health but I was probably about 60 when I had it. I don't tend to dwell on it or worry about it - can still drive ok etc.

My surgery was about £7000. Expensive but from my point of view worth it to not loose my sight. I didn’t like the idea of it and was quite anxious about the surgery but the reality was fine. I’m very happy with the results.

Thank you. Dh is only 40 so wasn't really expecting this.

That’s OK - I was late 40s and it was a bit of a surprise too. All turned out well in the end for me. Hope it does for you both too.

My DH did loads of research on my behalf and thought a referral to Moorfields was a possibility and encouraged me to consider it. I was able to have the treatment at my local hospital though. Could you contact Moorfields and perhaps get a referral there?

Maybe, yes. Have you reported to the DVLA?

See if your hospital has a listed eye clinic liaison officer who can talk him through everything.
Failing that option, if he doesn't already, get a good optometrist and book an appointment to discuss any concerns .
All optometrists understand glaucoma and the treatments, but you can search the optometrist register for independent prescribers local to you, https://str.optical.org who
have extra qualifications and often work at hospital eye clinics as well as in high street practice (with some also having an extra glaucoma certificate). If your husband does go to a new optometrist take all his hospital letters with him.
Glaucoma once diagnosed has different options for treatment and as long as he has regular check ups the NHS will look after him and his sight. Another option is to see the NHS consultant he is under for a private appointment and this will give him longer to talk through everything (at a cost- but could be reassuring).

Thank you for the information, I'll definitely get onto it. Knowledge is power. Did everyone report to DVLA? Has anyone lost their licence?

I can still drive with prescription glasses no problem.

I'm not sure going to an optometrist is worthwhile OP (and I'm one and I have IP status). The won't know what conversations have been had and it's not that common a condition, unlike open angle glaucoma.

Angle closure is when the drainage channel in the front of the eye for the fluid which gives the front of the eye it's shape (aqueous) gets blocked and that makes the eye pressure rise. This in turn can cause damage to the retinal nerve fibres at the back of the eye, which can then damage your vision.

Creating an extra drainage channel in the eye (a peripheral iridectomy) can allow the fluid to escape more easily, but anatomically as there are several explanations for the channel to be blocked, it doesn't sometimes work.

When is he due to go and see the consultant next? They will most likely carry out a CLE, which is like cataract surgery, there aren't really any other surgical options for this type of glaucoma.

You need to inform the DVLA if he has CAG in both eyes, or if he's a commercial driver with it in one eye.

The PP is correct - CLE is what I had. As you get older your lens thickens and narrows the drainage angle risking closing it completely. A replacement lens is smaller and opens up the drainage angle, solving the issue.

Thank you so much for this information. It's so worrying. He only has normal vision in one eye anyway, and this is in the other eye. Would this procedure be done on the NHS? Is it worth seeking a private appointment? He's been left not really know what's going on.

He's going in 4 months. Just picked up eye drops today. Do they have bad side effects, as the pharmacy are calling him later to check he's OK?

I was told lens replacement would only be done privately. NHS treatment was laser iridotomy only. I’d either contact your NHS consultant and ask or see a private one. I had mine done through Optegra. They do lots of normal cataract surgery for the NHS so I felt they were quality assured.

If it happens to be the Monopost Drops I mentioned earlier - the only side effects are slight discolouration but I have beautiful black long eyelashes as a result. I always did have black eyelashes but have now gone grey but for my eyebrows and eyelashes! I am very lucky to have been referred to a specialist eye centre but I don't think many areas have them? I'm in the extreme SE of England.

I meant this is in his good eye, he has very limited vision in his other eye.

They called Trusopt??

Honestly I am the biggest coward on this planet…. After opticians referred me to hospital for eye surgery I put this off for so long. Eventually I had no option than to go through with it & it was an actual breeze! Totally pain free both during & after surgery & wish I’d done it sooner.
Please reassure her that fear is the worst factor….not the treatment.
Wish her well.

Yes. If it’s his only good eye, I would absolutely seek a second opinion privately.
but don’t hold off using the monoprost, it’s usually very well tolerated initially.

Do we get a private referral via the GP?

I just phoned Optegra.