Dawn Asks:
I was diagnosed with Graves’ disease in 1987 and had radioactive treatment in 1994. Within one month I was hypothyroid with swollen, sore eyes. When the episode was over, I was left with double vision, dry eye and high pressure in both eyes. The morning pressure is now 23 ½, dropping to 19 in the afternoon. I'm on Restasis® drops - does this increase pressure? Do I need treatment or just regular check-ups for this pressure?

Prithvi S. Sankar, MD Responds:
Graves' disease can affect many parts of the body including the eyes. There is a higher rate of elevated intraocular pressure in patients with Graves' disease. Your intraocular pressure is slightly elevated and depending on an eye exam, you may need to be treated. Close follow-up is certainly warranted to make sure your pressure does not increase. Also, Restasis® is not known to increase intraocular pressure. If you would like another opinion, I or one of my colleagues would be happy to see you. You can schedule an appointment by calling 800-789-PENN (7366).

Phyllis Asks:
I have open glaucoma and have had laser surgery for closed glaucoma. My heart doctor wants to start me on Zocor. Information about Zocor says not to take it. The doctor advised me to ask an eye doctor. Otherwise, can I take Zetia?

Prithvi S. Sankar, MD Responds:
Zocor (simvastatin) and Zetia (ezetimibe) are medications used to treat elevated cholesterol. There have been no reports to my knowledge indicating that either medication causes or worsens glaucoma.

Paul Asks:
My ophthalmologist has been carefully checking my eye pressure for the past several years since it remains stable in the 19-20 range. I've been near-sighted since early childhood, and in my 20s progressed to a -9.5 in both eyes. I'm in my mid-50s now and was considering LASIK surgery to improve my vision without glasses. Is there an increased risk in LASIK surgery for someone with my level of optic nerve pressure?

Prithvi S. Sankar, MD Responds:
LASIK will cause changes in the cornea which may help you see better. However, these changes to the cornea may make measuring the intraocular pressure a bit more difficult. Should you decide to have LASIK performed, your ophthalmologist may measure your pressure with the traditional method, applanation tonometry, or by using a hand-held device, Tonopen. The hand-held device may be more accurate in the first few weeks after the procedure. Continued follow up is important. If you have any questions, you may contact your ophthalmologist or make an appointment with me by calling 800-789-PENN (7366).

Mom Asks:
My 25 year-old daughter has ICE syndrome. The iris of her left eye is disappearing, causing pressure to build - currently within the high range of normal. She is under the care of doctors at Penn Eye Care - one is a glaucoma specialist. Is it possible that the procedures described in this month's article might save her eyesight?

Prithvi S. Sankar, MD Responds:
Iridocorneal endothelial syndrome (ICE syndrome) is actually a spectrum of conditions that affect the cornea (the clear window of the eye where a contact lens would sit) and the iris (the colored portion of the eye). Glaucoma may develop in patients with this condition. The area between the iris and the cornea is where the drain of the eye is located and in patients with ICE syndrome the drain may not function properly. This dysfunction could lead to elevated intraocular pressure and glaucoma. The surgical techniques described in this article would only be used to treat advanced cases of ICE syndrome with glaucoma, but the evaluation methods for diagnosing glaucoma could be useful in identifying your daughter’s progression. Talk to her ophthalmologist about the best course of treatment available.

Hope Asks:
I had a closed angle procedure two years ago. Do I need additional medical attention? I was told then that a cataract was forming - but nothing has been done for this.

Prithvi S. Sankar, MD Responds:
It sounds like you had a laser iridotomy - a laser procedure that creates a very small opening in the iris. This opening prevents fluid in the eye from getting trapped behind the iris and causing an acute angle closure attack - a sudden attack of glaucoma. Normally this procedure solves the problem and does not need to be repeated if the opening remains clear. Only rarely is a second laser procedure (to reshape this iris) necessary. Cataracts are a cloudiness of the lens which is often age related. Many patients may have changes in their lenses that do not need to be surgically removed. You should consider cataract surgery only if you experience difficulty with daily activities due to impaired vision, or if your ophthalmologist feels the cataract may cause harm to your eyes. This is rarely the case.