Glaucoma Tip of the Month
Low Pressure Glaucoma:
One of the more difficult types of glaucoma to diagnose and treat is an entity called NORMAL PRESSURE or LOW TENSION GLAUCOMA. Usually one of the hallmarks of glaucoma is pressure in the eye, which is higher than normal. Usually, if we lower the eye pressure we can prevent further damage to the nerves in the eye and halt any loss of vision.

In this type of glaucoma the eye pressure remains in what we usually think of as the normal range but damage occurs to the nerves in the eyes and vision loss occurs. This can be very hard to diagnose because we usually cannot detect a problem until actual damage to the nerve in the eye can be seen on examination. So you may have an examination and have a "normal" pressure in the eye but damage can be occurring.

Usually, if we can lower eye pressure to a level of 18 or lower we can achieve success. In this disease we really do not know how low we have to go with the eye pressure to prevent further damage. Eye drops , laser and surgery are all helpful.

There is much research going on and one of the areas of research is to find a drug or treatment that protects the nerves in the eye from further damage. There are several that have shown promise but so far only in the laboratory. Tests are ongoing with a pill called memantine but so far no conclusive results. Interestingly, there is presently a form of this drug on the market called Namenda and is used to treat Alzheimer's disease. There is also an eye drop used to treat glaucoma, Alphagan, which is thought to have some nerve-protection powers. So far there is no direct clinical proof of this

There are numerous glaucoma specialists like me who are concerned about this disease and some are using these drugs in the hope that they may be helpful. I may be talking to patients about these drugs when I suspect they could be helpful.

About Dr. Mark Weiss

Mark Weiss, M.D. was born and raised in Philadelphia, Pennsylvania and received his undergraduate degree, with a major in history and membership in a pre-medical Honor Society, at Johns Hopkins University. He attended Medical School at Temple University and interned at the University of Chicago Hospitals. Dr. Weiss served in the military at Claremore Indian Hospital in general practice. After his military service, he returned to Chicago where he entered a specialty training program in Ophthalmology at the University of Chicago under the supervision of Dr. Frank Newell, editor of one of the major ophthalmic journals. Dr. Weiss was awarded a prestigious Heed Fellowship and spent an additional year at Presbyterian- St. Luke's Hospital in Chicago studying with Dr. Joseph Haas, internationally recognized clinician in glaucoma. In private practice in ophthalmology in Tulsa, Oklahoma since 1976, Dr. Weiss specializes in the treatment of glaucoma.
A Patient's
Guide to Glaucoma

is an illustrated booklet written by Dr. Weiss for the layman. In it he discusses the indications, symptoms, progression, and treatment of glaucoma, an eye disorder that can lead to blindness in people of all ages if not properly diagnosed and treated in its early stages.


1. What is Glaucoma? It occurs when there is an elevation in the intraocular pressure associated with changes in the nerve of the eye that initially result in the loss of side vision.

2. Can Glaucoma be Treated? Yes, but once a patient has glaucoma it never disappears. Dr. Weiss provides a treatment regimen consistent with the progression of the disease by prescribing: 1) eye drops, 2) pills 3) laser surgery and 4) conventional eye surgery, in that order.

His Guide also provides answers to dozens of other common questions patients have about glaucoma.

"Experience has proven that patience and careful checking and rechecking is rewarded by positive change. Stick with your medicines and treatment. Your eyes are worth it!" says Dr. Weiss.

You can e -mail Dr. Weiss about Glaucoma at:

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