Found Out I Have Glaucoma!

[newbegin4]

I just found out I have optic nerve damage from Glaucoma after having an ophthalmology checkup yesterday in Udonthani. I'm only 41 and I'm very worried as is my wife (I don't think she told me everything yet that the doctor said during their private Thai-to-Thai conversation).

Anyway, as I speak no Thai I'm feeling a bit lacking now in my ability to communicate with my doctor and even my wife about the intricacies of my condition, treatment and long-term prognosis.

Even though the doctor and my wife speak English quite well, there is still that last 10% of comprehension that eludes me and that makes it hard to get precise answers to my questions. Then there may also be cultural reasons for not speaking frankly. In the end I'm left with many questions and a lot of worries mostly about caring for, and not being a burden on, my family.

I need some support from anyone who speaks native English (I'm from the U.S.A.) who either has, or is familiar with Glaucoma. I'm not looking for a final diagnosis or anything like that (I have to wait for further tests) but the questions I need answers to are related with how to cope and manage the disease form a day-to-day perspective; whether the treatment regimes commonly available in Udonthani are adequate (up to Western standards); what to watch out for, etc. I really don't know all to well what to ask as I'm just starting out.

Unfortunately, my family and I don't have the financial resources to seek treatment back in the west, although we have pretty decent Thai medical insurance coverage.

My mobile number is 08 749 21046. My name is David. I really just need to talk to someone, thanks!

Edited September 6, 2010 by newbegin4

[lopburi3]

Important first point is what kind you have. Open angle or closed?

I have had open angle (which is more related to tests than a single factor) for last few years and for that the most important thing is control of eye pressure using daily medications. If pressure controlled believe most further damage can be averted. Have yearly vision field tests to check on loss and quarterly pressure tests/exams but so far it seems to be in a holding pattern and expect it will continue to be as long as I don't stop keeping pressure under control. Without control loss of vision would likely be the outcome. Daily eye drops are well worth the cost.

[sbk]

My FIL had stents put in at least 8 years ago, and his eyesight is still ok, he's 75 so he's got the usual deterioration but the side effects of glaucoma are, from what I know anyway, very very limited. he does take meds but not sure what, sorry. He had this done in Bangkok, I wouldn't trust any provincial hospital with this kind of procedure.

[Mobi]

Don't worry.

I too was diagnosed with glaucoma when I was in my early 40's and i am now 64 and can see perfectly well with glasses (for distance - I have always worn glasses) and without for reading and short distance.

I have been taking eye drops for over 20 years to control the condition and my visual field is still good enough for driving in the UK. (I have to take a visual field test every 3 years to keep my UK licence.)

I strongly recommend that you see an opthalmic specialist in Bangkok at one of the major hospitals. They all speak English and are usually very through with their examination and prognosis.

I used to see one at Bumrungrad, but I am sure that Sheryl will recommend you a few good names.

It won't cost you an arm and a leg either.

Glaucoma is not the end of the world provided it is caught early and treated.

[newbegin4]

I'm not sure what type I've got. The doctor did mention the word 'angle' but I thought that she was talking about my eye-glass prescription. Anyway, she really wanted to see my medical records from previous opthamologist visits. It has been about 4 years and it may not easy for me to retrieve those documents as I don't recall the name of the doctor, only a general location for his office back home (I'll have to do some research). Otherwise I've got an appointment scheduled in 3 months to see if there has been a change (for the worse). Personally, I'd rather not wait those 3 months prior to beginning treatment because that would be 3 months of irreversible vision lost.

One other thing, the tonography (air-puff-in-the-eye) test showed a normal pressure. That actually scares me because high-pressure can be treated....but what if my glaucoma developed despite normal pressure? In such a case, I wonder how to treat as all the medical options that I read about online focus on lowering high-pressure.

My wife if going to ask around for a specialist but I have a feeling that the better specialists are in Bangkok. Does anybody have a specific doctor that they can recommend who specializes in Glaucoma (even if in Bangkok)?

Also I recall from the exam that the optic damage was more advanced in the left eye, less so in the right eye. Is this normal?

Thanks, I really appreciate your replies.

[Thanyaburi Mac]

I'm not sure what type I've got. The doctor did mention the word 'angle' but I thought that she was talking about my eye-glass prescription. Anyway, she really wanted to see my medical records from previous opthamologist visits. It has been about 4 years and it may not easy for me to retrieve those documents as I don't recall the name of the doctor, only a general location for his office back home (I'll have to do some research). Otherwise I've got an appointment scheduled in 3 months to see if there has been a change (for the worse). Personally, I'd rather not wait those 3 months prior to beginning treatment because that would be 3 months of irreversible vision lost.

One other thing, the tonography (air-puff-in-the-eye) test showed a normal pressure. That actually scares me because high-pressure can be treated....but what if my glaucoma developed despite normal pressure? In such a case, I wonder how to treat as all the medical options that I read about online focus on lowering high-pressure.

My wife if going to ask around for a specialist but I have a feeling that the better specialists are in Bangkok. Does anybody have a specific doctor that they can recommend who specializes in Glaucoma (even if in Bangkok)?

Also I recall from the exam that the optic damage was more advanced in the left eye, less so in the right eye. Is this normal?

Thanks, I really appreciate your replies.

xxxxxxxxxxxxxxxxxxxxxxxxxx

Go down to the Petchburi end of Sukumvit Soi 21, Soi Asoke, and check out the Rutnin Eye Hospital.

http://www.rutnin.com/eng/html/about.html

I've been seeing and been treated by Doctor Chaiwat Teekhasaenee, M.D. for 15 plus years, including two cataract opns two laser zaps, and a "trab" on my right eye, and am very satisfied with the treatments received.

BTW, he speaks quite excellent English.

I was diagnozed with glaucoma in one eye back in 1984 when I was in my mid-40s, the eye doc then, in the U.S., told me I'd be taking eye drops for the rest of my life. So be it. Not a problem, given the alternative. BTW, "pigmentary" glaucoma.

Catch it early and arrest the progression of the diease, for the most part, early!

Mac

[DocJD]

Most glaucoma patients will need to use eye drops daily. The main function of the eye drops will be to lower pressure in your eye. The way these glaucoma drugs work, depending on which ones you receive, will either be to reduce the amount of aqueous fluid produced in your eye or to improve the efficacy of the system which drains excess fluid from the eye. The latter drug, known as a prostaglandin, can change the color of one's iris to brown. Glaucoma is manageable. With proper treatment, you can stop the vision loss from progressing. And even though your eye pressure may be w/in normal range now, it can fluctuate greatly.

There are also surgical treatments available, such as laser treatments which can open the trabecular meshwork that drain fluid from the anterior chamber. In some cases, surgeons can install drains which remove excess the fluid from within the eye and indirectly route it into systemic circulation.

Most patients opt for medical treatment over surgical.

As for seeking treatment in Thailand; an eye specialist theoretically should be able to diagnose and medically treat you for glaucoma. Personally, I think they do decent dentistry in Thailand, but I've never been a big fan of their medical practices. Regardless, if you have any other conditions (diabetes, hypertension, COPD, etc) then make sure you tell your ophthalmologist.

[gguy]

I'm not sure what type I've got. The doctor did mention the word 'angle' but I thought that she was talking about my eye-glass prescription. Anyway, she really wanted to see my medical records from previous opthamologist visits. It has been about 4 years and it may not easy for me to retrieve those documents as I don't recall the name of the doctor, only a general location for his office back home (I'll have to do some research). Otherwise I've got an appointment scheduled in 3 months to see if there has been a change (for the worse). Personally, I'd rather not wait those 3 months prior to beginning treatment because that would be 3 months of irreversible vision lost.

One other thing, the tonography (air-puff-in-the-eye) test showed a normal pressure. That actually scares me because high-pressure can be treated....but what if my glaucoma developed despite normal pressure? In such a case, I wonder how to treat as all the medical options that I read about online focus on lowering high-pressure.

My wife if going to ask around for a specialist but I have a feeling that the better specialists are in Bangkok. Does anybody have a specific doctor that they can recommend who specializes in Glaucoma (even if in Bangkok)?

Also I recall from the exam that the optic damage was more advanced in the left eye, less so in the right eye. Is this normal?

Thanks, I really appreciate your replies.

xxxxxxxxxxxxxxxxxxxxxxxxxx

Go down to the Petchburi end of Sukumvit Soi 21, Soi Asoke, and check out the Rutnin Eye Hospital.

http://www.rutnin.com/eng/html/about.html

I've been seeing and been treated by Doctor Chaiwat Teekhasaenee, M.D. for 15 plus years, including two cataract opns two laser zaps, and a "trab" on my right eye, and am very satisfied with the treatments received.

BTW, he speaks quite excellent English.

I was diagnozed with glaucoma in one eye back in 1984 when I was in my mid-40s, the eye doc then, in the U.S., told me I'd be taking eye drops for the rest of my life. So be it. Not a problem, given the alternative. BTW, "pigmentary" glaucoma.

Catch it early and arrest the progression of the diease, for the most part, early!

Mac

Rutnin seems to be the place to go. I would seek multiple opinions. Make some appointments and come to Bangkok for a week. Each opinion should not exceed 1000 baht plus tests. Bring all your test results to each appointment to avoid duplication of tests. Try to read up on internet and see what treatment options are available and discuss the options with each doctor. Develop a list of questions and treatment options and compare doctor visits and then reinterview doctor that meets your qualfications and begin treatment. Be as organized as possible to get the most info. Good Luck.

Edited September 6, 2010 by gguy

[newbegin4]

Thanks everyone. I've printed out the Rutnin Eye Hospital information and will be giving it to my wife. It was good to hear also that the eye pressure can vary (as opposed to being constant). That gives me some hope that this disease will be treatable. I accepted that I'd be able to cope with blindness on a personal level, but not with being a burdon on my family (i.e. loss of income) so it is nice to hope that I can keep what I still have and continue to provide for my family.

Edited September 7, 2010 by newbegin4

[lopburi3]

This is something that many people are living with and will not go blind because of it when they know and treat.

As said Rutnin Eye Hospital is the standard and has been so for over 30 years that I have used them. My primary doctor is at another hospital but have annual VFT done there and would highly recommend as they appear to not only know what they are doing but do it at reasonable prices.

[Sheryl]

As others have said, this is a fully treatable condition, although it will require treatment (medication and regular follow-up)for life.

If you have any visual impairment already, it will remain, but with treatment any further damage can be averted.

Agree 100% with the recommendation of Rutnin as the place to go. It's worth travelling for. Do not mess about with doctors upcountry, at least not at this stage. Once you are under the care of a specialist at Rutnin, it may be possible to get some routine follow up done in the provinces in accordance with his specific instructions.

It is also quite important to rule out diabetes if this has not already been done: a blood test for fasting glucose and Hb1Ac. If you are diabetic or even pre-diabetic, this needs to be addressed in order to keep your glaucoma under control as well as to avoid other complications, both of the eyes and other organs.

In fact a general physical check up would be wise, especially as you will be coming to Bangkok anyhow. You'll need to go to another hospital for an overall check up as Rutnin is exclusively for eyes, although Rutnin can probably do the diabetes screening for you. There are several good international hospitals located not very far away from Rutnin. Bangkok Hospital would probably be the closest. http://www.bangkokhospital.com/index.php?p=en/in_Healthy_Checking_Adult_bgh

[newbegin4]

Thanks everyone for your replies with good information. My wife just told me that insurance will probably not cover any Glaucoma treatment. I had been under the impression that we had good coverage, but it seems not. I don't fully know, or understand, the reasons about this but anyway we'll have to have treatment here in Thailand no matter what as we don't have the financial means to do so back in the States.

I understand that there are a great many different medications and/or procedures so the long-term financial impact of treatment can vary. I'd appreciate knowing what the experience of others is with regards to the on-going cost of treatment. I expect an initial round of examinations to nail down the exact type of Glaucoma, regular checkups for life and then routine medication expense. What can we expect? How much in funds should we try to scrape together for an initial round of consultations at Rutnin Eye Hospital? What will be the recommended schedule of follow-up visits (cost & frequency). What is the range of medication prices?

Any help in sorting out these long-term issues will be a great relief as my wife and I discuss how to rearrange our life to deal with this disease.

Thanks!

[Thules]

OP, you've received great here advice . My friend and neighbour has glaucoma, and has been successfully treated in BKK for many years now. Get reliable pressure tests, and please follow poster's suggestions. Good on previous TV posters !

Best wishes

[ericg1953]

I also was diagnosed with glaucoma and have been going to Rutnin seeing Dr. Hathairat Pipivijitkorn. She is a good Dr. with good spoken english and judging by the amount of patients she has, seems to be very popular.I find her to be very thorough and the hospital staff as well. Rutnin is a well run eye hospital and I think their pricing is very fair also. I will add one thing, it was during my yearly "package" full physical I have at one of the major hospitals that the glacoma was detected. So yearly checkups are really a great thing in this country and fairly priced.

[lopburi3]

At Vejthani (higher priced hospital but not highest) I pay about 700 baht every three months for doctor consult/eye exam/pressure by computer air puff and normally double check with drops and slit lamp exam.

Annual CVFT at Rutnin at 600 baht.

Medication Travatan at local pharmacy 720 per month

Medication Nyolol at local pharmacy 165 per month

Total monthly cost about 1,170 baht.

[Thanyaburi Mac]

At Vejthani (higher priced hospital but not highest) I pay about 700 baht every three months for doctor consult/eye exam/pressure by computer air puff and normally double check with drops and slit lamp exam.

Annual CVFT at Rutnin at 600 baht.

Medication Travatan at local pharmacy 720 per month

Medication Nyolol at local pharmacy 165 per month

Total monthly cost about 1,170 baht.

I'm on Xalacom & AZOPT, which I buy at a local "Lao" pharmacy in the Rangsit Market ("Lao" only because several of the gals are from Issan and speak the lingo). No problem with the doc at Rutnin when I say I'll buy the meds myself, cheaper (read, "less expensive") outside the hospital. I don't have the costs handy as I'm back in Oregon for a few weeks.

Mac

[kebabby]

I know this is a very old post but there's not many on the subject. 

 

3 months ago, a routine eye test showed high pressure 37 and 28 and I was diagnosed with glaucoma. I went to Surat Thani Eye Hospital for tests. Doctor said he would like to wait 3 months before starting drops because of my age (51) and my health is good. My blood pressure was 111/67.

 

Obviously, I was worried so did a tonne of research. I started immediately taking the tablets below. I also quit coffee and caffeine, I started drinking hot chocolate made from cocoa mass. I reduced my sugar by over 50%. I started taking the dog on an extra walk, so about 8km total. 

 

I don't drink often and when I do, its no more than 4 beers, so I didn't change that. I smoke around 10 a day, I never stopped. 

 

Just been for my 3 months consultation and my tests are all normal. Blood pressure 106/63. Eye pressure at 17 and 16. He gave me all clear, asked me to go back in 6 months. 

 

Vitamin B Complex

Vitamin C 500mcg

Vitamin D3 100mcg

Vitamin K2

Magnesium Complex

Ginkgo Biloba

Bilberry Extract

Collagen