New Thoughts in Glaucoma Management

In this lecture, John Berdahl, MD covers the changing paradigms of glaucoma management and talks us through how one scuba diving trip led him to develop a hypothesis about CSF pressure and its relationship with glaucoma.

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[rickclark]

Severe glaucoma patient here. Congrats on your great insight, it makes so much sense. I used to SCUBA and freedive a lot myself and after my diagnosis I worried I may have done it to myself. One of my docs even said it made sense. Now I know better! Also after diagnosis I read up to understand my disease better but so much didn't seem logical such as why would normal IOP people get it or why would high IOP people escape it. Now it all makes perfect sense! And if you ever do come out with some goggles, please make them cool looking :-) .

[sishrac]

Congrats on applying the true scientific process for solving a real problem. Hope you'll keep thinking outside the box to keep the solutions wholistic.

[kentdeines]

Im an electrical engineer with glaucoma. The focus on IOP has always bother me. The fact that it needs to be compared to something, I was thinking arterial blood pressure at the entrance to the eye, is in the damn obvious class. The association of glaucoma and IOP goes back an easy 100 years and only now somebody thought about this is very disappointing, Congratulation on being the one.
Let me add that the arterial pressure has to be greater than the ICP if blood is to get to the brain and above both ICP and IOP to get into the eye. Low ICP permits lower arterial pressure while supplying the brain with blood hiding low arterial pressure against IOP that otherwise would have caused fainting.
I am also concerned that lowering the IOP against the ICP would cause the eye to dis-inflate, causing it to change shape and screw up vision. I have tried and rejected some eye drops because I lost visual acuity. I'm wondering if it is because they worked too well and my eye changed shape because if dis-inflated.
Congratulation!! and good luck.

[davepark]

Would the next step potentially be with some device etc to stop the damage from occuring give the opportunity for some type of cell therapy to take place to maybe repair the damage already done to some degree?

[dr.amitabhamukherjee]

If the crux of this argument is lowering the IOP (relative to the ICP) in Normal Pressure Glaucoma, why not use an eyedrop at bedtime to keep the IOP 'suboptimal' in this subset of patients, say around 10-12 mm.Hg?

[Dr.CandanEsin]

Probably I missed your disclaimer that all glaucoma is not equal. There are diverse types of glaucoma based on cause, mechanism, and complications. The most prevalent one could be pseudo-exfoliative glaucoma which has little to do with intraocular-corporeal fluid dynamics. Though the video overall touches on a very delicate issue for scientists to think of.

[rickcantu]

Anything in the near future for open angle glaucoma patients

[omifunkemccloud]

Can you explain the relationship between Glaucoma and lymphatic system

[MelissaBliss]

I can't help but ask/wonder if high blood pressure also relates to this (& whether dietary changes like adding oatmeal and flax seeds everyday, which brought down a friends high blood pressure to normal) might also help.

[abiodunolubajo]

How does this benefit somebody like me that have glacoma about to do surgery to reduce the eye pressure.

[leocardiabyenkya]

My friend is 47 yrs old, he is blind! Can this bring back his sight?

[lanesue]

Does this include Pseudo exfoliation Syndrome?