I was diagnosed with glaucoma at the age of 17 by a doctor. It was hard for me to comprehend that I'd have to take drops for the rest of my life. I do have pretty bad myopia and astigmatism. This was in the middle east. On doing a recheck back in India, I had a very comprehensive testing with multiple doctors checking for glaucoma and retinal damage and was told that while I'm a suspect, there's no reason for me to take drops. My IOP was calculated taking into account the diameter of the pupil (I think) and Goldman test which wasn't done previously. The doctors proceeded to explain that in the west, doctors are more likely to prescribe treatment for glaucoma because of all things around insurance etc. At minimum, I recommend getting a second opinion, if possible from a country that's not riddled with such insurance schemes.
There are several difficulties when it comes to managing glaucoma:
1) There are different types of glaucoma that have different diagnostic criteria
2) Different people have different risk factors for glaucoma development, disease progression, and treatment response. What works for one person may be completely ineffective for another
3) Our glaucoma data (for diagnosis, progression, treatment) is largely based on a cohort of data gathered from Caucasian patients; researchers and clinician are generating population-specific (Blacks, Asians, etc,) data, but there's definitely still a long way to go
4) There is some subjectivity that goes into diagnosing/treating/monitoring glaucoma, which is why one doctor may decide to start you on drops while another may choose to observe without intervention -- in cases that are not clear cut, either approach may be correct
Thanks for your story. I hear what you are saying and I do plan to get a second opinion. Apparently here in the US there are some people who have had their glaucoma un-diagnosed.
But I have some confidence that its real. First, my doc wasn't eager to do it, she just suspected it at first, and we did some tests and waited for a while. But later, a followup visual field test did show some actual loss in one of my eyes, but not something I noticed.
The whole business with the drops is annoying, but its not unexpected. Still, that would be a business model worth disrupting.
