Living with Severe Closed Angle Glaucoma

I was at work when the vision in my left eye became scrambled, wavy and grayish. All of the colors were gone. Terrified, I fled to the eye doctor for the first time in 15 years, and found out that severe, undiagnosed Closed Angle Glaucoma had crushed my optic nerve, and I was going permanently blind in my left eye. Nothing could be done. After 9 surgeries to save the eye, simply in a physical, non functional sense, all efforts failed, and it had to be surgically removed. I have a very nice, expensive Hydroxyappetite prosthesis installed there today. No one can tell the difference, a small consolation, but still some.

Normal eye pressure is 15-20 mmHg, and my remaining "good" right eye measured 31 mmHg, way too high a number that would certainly destroy my optic nerve in this eye, over time, as well.

My Opthamologist gave me a pressure reduction eye drop called Cosopt, which worked perfectly for a considerable period of time, about 5 years, before my condition worsened. Using Cosopt is not without side effects, however. One of the active agents in Cosopt is Acetazolamide, also prescribed for altitude sickness as well as Glaucoma under the trade name Diamox. Acetazolamide has numerous unpleasant side effects, including a vexing numbness in the hands and feet, a metallic taste in the mouth and mild depression, to name the most obvious and discernable few. As events unfolded, my condition worsened, and Cosopt alone was not enough, and by 1999, Doc added another drop called Xalatan in combination with Cosopt, and that worked well for about another 3 years or so. Sometime in 2002, my intraoccular pressure sky rocketed out of control, up to 55mmHg, requiring a trip to the emergency room.

What does an intraoccular pressure of 55mmHg feel like?

Your vision begins to white out, milky foggy white, until you can barely see. You see rainbow halos, complete with nicely divided, very pretty colorful diffraction patterns that can put any post-rainstorm light show to shame. Very beautiful, very sinister You feel severely disoriented and nauseous, and experience severe eye pain and headache. This is an especially dangerous time, as an eye pressure of 55mmHg can crush the optic nerve within days, or even hours, and once the optic nerve is dead, it's over.

At the emergency room, they gave me the heavy hitter of intraoccular pressure reducers, Pilocarpine. Pilocarpine has many severe, life altering side effects. It reduces pressure by shrinking the size of the pupil, which causes vision acuity to change dramatically. For several hours, I can only see objects a few feet in front of me, making driving impossible, and even walking stairs perilous, along with headaches that rival most migraines. But at least for the time being, my pressure is under control, at least most of the time. If I skip a dose of any of the three drops I use, the halos return, telling me my pressure has sky rocketed again. There is a great danger in this pattern, however. After all, there is only so much beating the structure of the eye can take before it fails, literally like an over inflated tire.

Managing my condition is a full time occupation. I use one drop of Xalatan a day, two drops of Cosopt and four drops of Pilocarpine, which entails setting my clock to get up at 5 in the morning, as the chemicals metabolize as you sleep. I give myself at least an hour after I use Pilocarpine to allow my vision to return to normal and the headaches to fade. I work in phone tech support, so my overall routine is basically tolerable and doesn't endanger anyone, but certainly is demoralizing. Missing a dose means halos, which means potential blindness, keeping me very strongly motivated to stick to the meds. A crowning understatement, indeed.

And yes, I did apply for Federal Disability, but my claim was denied. Why? They unabashedly informed me that unless I am completely blind, I could not get approved. In other words, come back and re-apply when you're totally blind.

I went in for a newly perfected type of pressure reduction laser surgery in 2003, which had no effect at all. My last recourse is to have invasive surgery called Drainage Implant Surgery, where a drainage conduit in surgically implanted in my eye, but such a procedure is fraught with risks, and there is at least a 50/50 chance of complete blindness in my case. So, for the time being, I have chosen the 'safer' route, to live and suffer each day around an almost absurd regimen of powerful chemical drops that burn, lacerate and tatter my cornea and sap my strength and motivation. At this point, unless I risk serious invasive surgery, there simply is no other way out. There are limits to what modern science can offer man, after all.