Glaucoma and Latanoprost

Hi everyone, as some of you might have been aware, I've been a glaucoma suspect for about six years. Last week, at my annual eye appointment, I saw a new doctor (my consultant previously was a student of mine who is now unfortunately on medical leave due to having cancer). The new doctor was rather rushed; he didn't do an OCT scan, and he immediately put me on Latanoprost without any discussion. It was pretty much just here, take this, see you later kind of thing.

I've been on Latanoptost for two days, and my eyes feel strange. I feel I have an increased sensitivity to daylight, and I'm noticing my floaters a lot more. I'm also more aware of flashes and light retention when blinking. It's giving me a lot of anxiety because that's my nature. The thing is, I'm not sure if it's just me being neurotic, as I usually am when dealing with health issues like this, or if things are actually different.

I knew sensitivity to light was a side effect before I took them, so part of me is questioning whether I'm convincing myself that I feel different when maybe my eyes were always like this. Still, now I'm just hyperanalysing my vision.

When I was under my student's care, things were very different. He took his time, was methodical, and discussed all possible options at length with me.

I am still technically ocular hypertension rather than confirmed glaucoma, so the drops are a preventative measure.

I feel like I'm going down a rabbit hole of despair again, and this has been my support network for a decade now. Who else here uses Latanoprost?

 

I can’t help you with the Glaucoma or medication.

But I’m well aware of what anxiety can do, and it’s certainly caused me issues with my eyes. I have had amblyopia since birth, and I’m very accustomed to my vision, but on occasion, my anxiety can latch on to me thinking my eyesight is different than what it normally is; I’m focusing on it constantly and trying to prove to myself it is or isn’t different.

I can’t avoid seeing these ruminations happen for 2-3 weeks before again they fade into the background so as not to bother me. But during those episodes, I am hyper-fixated on everything eyesight-related, so it makes sense to me that you’ll notice your usual floaters more.

I also get light retention with the flashes and blinking with those episodes; it is simply just because you’re now paying attention to what has been an automated process for the last 30 years.

 

I'm exactly in the same position - at risk of Glaucoma with a large optic nerve cup-to-disc ratio, so even though my eye pressures are normal, I'm using Latanoprost to bring my eye pressures even lower as a preventative measure. I've been on it for about two years now with no obvious side effects, as you mention. There was no change in my eyes over that period either - I have a very good ophthalmologist who even suggested that the Latanoprost might not be necessary. Still, it was up to me if I wanted to continue, so I am.

She also mentioned other options, such as very safe laser surgery that will lower pressure without the use of eye drops. In Europe now, this is becoming the first-line treatment by many doctors, but the US is lagging behind and is more conservative. It is an option, though, if I were to ask for it—maybe you want to look into it.

Alternatively, there are other drops you could also try. Initially, I was on a newer one called Vyzulta, but it was very expensive, and my insurance wouldn't cover it. So I started mail-ordering it from Canada for a fraction of the price, but it was a hassle, and I switched to Latanoprost when I saw I was getting almost the same pressure reductions.

Two days seems very soon to be seeing side effects - it takes longer than that to bring down eye pressure, but I'm no expert, so it is probably best to ask your doctor.

 

This is the problem with how my brain works. I look for problems until I make myself unhappy. The floaters and flashes are far more noticeable when outside, but I'm self-aware enough to realize that I'm probably amplifying this perception myself because I am now monitoring my eyes. This is something I've never done before, so it could be that what I was previously ignoring I am now viewing as an issue.

I'm at the mercy of what the NHS will prescribe me.

I was aware of the laser surgery but that is probably overkill for me at the moment.

I think I need to follow my tinnitus protocol of keeping my mind focused on other things so that I don't think about my eyes. It's unbelievable the amount of torment you can cause yourself over something that has most likely always been there. A change in one’s perception can alter reality.

 

Hey Ed!

I am sorry you are experiencing ocular hypertension.

My mother suffered with this, but was managed with laser treatment - successfully.

Late last year, I noticed a large mobile C shaped floater in my right eye out of nowhere.

Immediately, my anxiety spiked.

I had been aware of small floaters for years, that were only visible in the light.

This was different. The floater made it impossible for me to read, or focus on anything without the interference of a prominent black C floating in my field of vision.

I even considered wearing an eye patch because I couldn't stand seeing the floater.

Once my ophthalmologist informed me of the risk of retinal detachment, and that it would likely happen to my other eye, my anxiety decided to take a vacation on another planet!

I presume your ophthalmologist has confirmed no sign of retinal issues?

I was inconsolable and certainly didn't believe that I would get used to the floater and/or it would improve.

I visited a surgeon, who agreed to consider surgery if, in a year, I had not habituated to the floater.

I won't need to, though. Most of the time, I am either not aware of it or bothered by it when I do notice it.

I remember wearing stenopeic glasses during a visit to my specialist. I totally freaked out because I realized that my entire field of vision in both eyes was covered in floaters. I had no idea! I was told then that my brain had been filtering them out.

I am not sure my post is helpful to you, Ed. I guess I am just trying to say that I can relate to your fears and wanted to reach out to you as you have done for me during times of heightened distress. X

 

They said my retina looked fine. I don’t think that my eyes like the drops as they look a tad redder than usual, but I sometimes do have slighter, redder eyes because of my allergies, so they might actually be no different. My problem now is that I’m going into obsessive territory, overanalyzing and overthinking every aspect of the drops. If my eye so much as itches, I blame the drops, etc. The blood vessels in my eyes also look more inflamed than usual, but I never studied them beforehand. This is the very definition of going down the rabbit hole for me. When I get like this, I can drive myself insane. I need to break these behavioral patterns before they drag me down; the devil on my shoulder won’t stop saying things like the drops are causing the floaters and the inflamed eye veins, and the flashes, etc, and the logical side of me is saying they were always there. There’s probably little chance any of this is due to the drops other than maybe some discomfort.

Not knowing for sure, however, will probably give me a lot of mental anguish until something else comes along that's worse, and then I'll focus on that instead. I probably have some form of OCD.

 

Hi @Ed209,

I’m a lot older than you. I also have ocular hypertension. I’ve had laser treatment twice, but it didn’t resolve the problem.

Latanoprost is unlikely to cause worse eye floaters. I became l obsessed with the veins in my eyes! Sheer anxiety in my case. It’s so easy to become scared and let your imagination run riot.

I have annual hospital checks, and there has not been any deterioration so far.

I wish you some peace of mind.

 

The drops they gave me contained benzalkonium chloride.



After researching this preservative, I found that it’s a toxic substance known to cause multiple issues.







After about seven days, I went back to the hospital and told them that I suspected the preservative was irritating my eyes. The doctor I saw agreed that it was a common issue and switched me to Monopost (the preservative-free version of Latanoprost).

I have to question why they don’t just give out the preservative-free version to everyone in the first place, especially after I read that the EU wants to ban BAK. It is obviously down to cost, as I’d imagine it’s cheaper to produce the single-bottle version with a toxic preservative added in than to make the single-use tabs that are preservative-free.

Anyway, my eye irritation has reduced substantially since using Monopost.

 

Monoprost has tinnitus as a side effect. I used it for nine months, and I suspect it is responsible for my tinnitus.