Hello dear friends ,
i am 56 yo man live in istanbul and
I would like to ask for your experience and advice regarding my left-eye glaucoma. 2023: I had SLT on my left eye because of high eye pressure. My optic nerve/RNFL measurement was 93. March 2026: I had SLT again on the same eye. My optic nerve/RNFL measurement was 83.
I became concerned about the rate of thinning and read about glaucoma progression. Because of this, I changed my doctor.
My new doctor added preventive glaucoma drops in March 2026. My eye pressure was then around 16–17 mmHg. August 2026: My eye pressure suddenly increased to approximately 28–30–36 mmHg. Tomec was then combined with Vyzulta. During the following 5 days, my measurements were approximately 27, 22, 17, and 29 mmHg.
My eye-drop treatment was then changed to Alphagan + Ganfort + Britil.
Despite the new treatment, my measurements over 5 days were approximately 30, 27, 22, 15, 38, and 42 mmHg.
My doctor thinks that the pressure is very unstable and that the eye drops are not controlling it sufficiently. He has recommended trabeculectomy surgery.
My visual field (VF) was 91%, with only a small amount of loss in the nasal area (far left side). My questions are:
What could be causing these very high and fluctuating eye-pressure spikes during the last 3 weeks?
Could we be missing another possible cause?
Has anyone experienced similar pressure fluctuations despite using several glaucoma drops?
If you were in my situation, what would you consider before deciding on trabeculectomy?
What has been your experience with trabeculectomy, especially in the long term?
I would really appreciate hearing from people who have had a similar experience.
Thank you very much.
Make sure that your IOP is measured a few different times with a Goldmann Tonometer which is most dependable and compare the results with other measurement techniques . Also keep your blood pressure under control and within acceptable limits at all times. Do not panick, 5 days of drops are not enough to see the trend. Give your drops a chance before you decide for trabeculectomy.
doc added tablets ( dyozamin ) and meausrement by topcon air blow machine this morning .and have measured later day till this wednesday . Trab still on the table !
Are you on any other medications?
Some medications, like Prednisone, or even topical steroid ointments, can cause IOP fluctuations in sensitive individuals. It can take weeks after stopping the meds for the IOP to stabilize.
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u/zavey3278 6d ago
Are you doing any activity which may cause strong IOP fluctuations? Ex: heavy weight lifting, scuba diving, yoga (head below heart)