We have visited the doctor this past week ..to get the news added on top of FrontoTemporal Dementia ...now my husband has glaucoma. Is there any correlation with Dementia patients and Glaucoma? No one in my hubby's family has blindness, glaucoma, macular degeneration, these were the questions the doctor asked, after being there for 3 hours of numerous tests now we have this to deal with.
My wife M was diagnosed with glaucoma two months ago. She is 75 and in AD stage 6+ or early 7 maybe. Her eye doctor prescribed Xalatan 0.005% eye drops. Administered as one drop in each eye at bedtime.
The doctor told me he prescribed that medication for my sake, so I would not have the additional stress of the usual 4 times a day eye drops used for glaucoma.
She also needs cataract surgery, but that is impossible as she can't handle the post operative care.
I am an optometrist who works alongside 5 ophthalmologists in an eye clinic. My wife has had EOAD for 5 years - so now I do a lot of reading on eyes AND dementia. I have never read anything in the professional literature linking AD/dementia with glaucoma.
Yes, but FTD, your husband has at least one autoimmune disorder, doesn't he? And there is growing evidence that autoimmune mechanisms may be involved in glaucoma, at least in some glaucoma patients.
That article is from 1995. Not much really came from that idea/research. NTG (normotensive glaucoma)/LTG (low tension glaucoma) (nobody ever calls it NPG) is certainly a different entity than POAG (primary open-angle glaucoma - the most common form of the disease). LTG is multi-factorial in nature - the best description I've heard about it is "A sick eye in a sick body." We see more of it in patients with vaso-spastic disease and cardiac arrythmias/insufficiency.
When I last spoke to my wife's neurologist at Mayo I did ask him what he thought might be the most promising avenue of research in treating AD - it didn't take him a second to reply, "anti-inflammatories". There was a wonderful article in Scientific American about 2-3 years ago detailing the role that inflammation plays in the pathogenesis of cancer, diabetes, Alzheimer's, heart disease and macular degeneration.
iggy, I didn't bother worrying about the early date on that particular article, because I saw so many dozens of other articles published in the last three or four years. Most of them had a lot more technobabble, so I thought this one might be easier for FTD to understand.
FTD's husband has been tentatively diagnosed with a bunch of autoimmune disorders, not just one ... and I considered the relationship between autoimmune disorders and dementia to be very well established, due to the very detailed, earlier evaluation I did on the autoimmune diseases her husband apparently has. So it just seemed, intuitively, that the tie is likely to be between his autoimmune disorders and the glaucoma, rather than the dementia per se and glaucoma. I.e., autoimmune problems are causing both in her husband, rather than the dementia causing the glaucoma.
For example, I found one paper linking thyroid disease and autoimmune disorders with glaucoma, and if I recall correctly, FTD's husband has an autoimmune thyroid disease: http://www.nature.com/eye/journal/v18/n6/full/6700731a.html
I didn't specifically look for any others, although this paper does cite a few.
A few of the many other papers linking autoimmune disorders and glaucoma: http://www.nature.com/scibx/journal/v1/n43/full/scibx.2008.1038.html http://www.molvis.org/molvis/v13/a175/ http://www.iovs.org/cgi/content/abstract/47/3/968 http://www.jneurosci.org/cgi/content/abstract/28/46/12085 http://www.ncbi.nlm.nih.gov/pubmed/17072291 http://www.ncbi.nlm.nih.gov/pubmed/17385943 http://www.ncbi.nlm.nih.gov/pubmed/18193265 http://www.ncbi.nlm.nih.gov/pubmed/18303391 http://abstracts.iovs.org/cgi/content/abstract/46/5/1285 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2493027 http://www.ncbi.nlm.nih.gov/pubmed/18330572 http://www.molvis.org/molvis/v10/a17/ http://www.iovs.org/cgi/content/full/48/2/705 http://www.ncbi.nlm.nih.gov/pubmed/18350436 http://www.ncbi.nlm.nih.gov/pubmed/15036560
Now, I wasn't looking for a correlation between glaucoma and Alzheimer's, since FTD's husband has (surprise!) FTD. But in going back to look for the links for papers on glaucoma and autoimmune disease so I could reference them for you, I looked a little more closely at a few of the papers. The latest ones say that there is a strong link between the basic cellular processes in glaucoma and Alzheimer's disease (see, e.g.: http://www.pnas.org/content/104/33/13444
In fact, I saw papers that call glaucoma "ocular Alzheimer's disease". See: http://www.ncbi.nlm.nih.gov/pubmed/12957857
I found papers back as far as 1997 discussing the parallels in the cellular mechanisms underlying glaucoma and AD. (I didn't look any earlier than that.) There are so many in the recent literature that I gave up trying to read anywhere near all of them ... I stopped after the first 50 hits (from 4,680) in articles since 2004.
There have been reports of a high occurence rate of glaucoma among AD patients. See, for example: http://www.ncbi.nlm.nih.gov/pubmed/11914555 http://www.ncbi.nlm.nih.gov/pubmed/16564058
AD patients have a reduced number of optic nerve fibers, and a greater odds ratio for a larger optic cup-to-disc ratio than healthy patients. http://www.ncbi.nlm.nih.gov/pubmed/17130422
Conversely, another study found that patients with glaucoma do not appear to be at increased risk for developing AD (although the conclusions were only tentative). See, e.g.: http://www.ncbi.nlm.nih.gov/pubmed/17224749
And there's been a clinical trial on using Namenda to treat open-angle glaucoma, although I haven't seen the results yet.
Interestingly, I found a number of papers that tied Helicobacter pylori to both glaucoma and AD as a possible common underlying risk factor.
This is all very interesting, and there are so many, many more papers ... but ... I have to go fix dinner -- my husband has been very patient but he's getting hungry!
- Interesting association between H. Pylori and AD. My wife had significant ulcers in the late 70's/early 80's before we were married. Who, at that time, thought they were caused by bacteria?
- I would expect a reduction in ON fibers and, therefore, a larger C/D ratio in AD patients. Brain rot would result in retrograde axonal degeneration along the visual pathway.
- There may be an autoimmune component to AD but, at this time, I don't think this is accepted as gospel fact. I think it is seen as more of an inflammatory process which is a little different than a true autoimmune process (although they do share some common characteristics).
.. ok, past the technical stuff, the anti-inflammatories like nsaids, which I give for arthritis and take myself, might actually be helping the dementia? Sometimes I think he's really in pretty good shape, watching documentaries and talking about them cogently, even days later, and then he does something like pour himself a little more wine - into his salad bowl. But really, there hasn't been much mental decline in the past year. Some physical, but he's 84! and he does take anti-inflammatories diligently.
Thanks for all the reply. It amazes me when you visit different specialist and you have to fill out the new patient form once they look at his diagnosis (FTD) and symptoms all you hear is " he is so young" have they found out what has caused this? The doctors are around his age and it seems as if they are clueless to how many people have FTD/EOAD. ALso again his ANA level is extremel high and they are requesting we see a rheumatologist again
Nothing scientific here; I just searched for "glaucoma" and came up w/this thread not wanting to start something new.
My hb was diagnosed w/early signs of glaucoma because of pressure measurement and was given an Rx for Xalatan 0.005% eye drops--1 drop in left eye at bedtime. He "cannot" open his eye; squints when I try to hold lid open as nurse showed me. He "hates" it more than anything he said. Tonight he said "NO"! He wouldn't let me put the drop in, and I surely can't wrestle him to the ground. He's still physically fit. He said he doesn't care if he's blind. I told him I'd be phoning the doctor, but he doesn't care. Always been a stubborn so and so, but very willing to take other meds. Guess this is just a vent; thanks for "listening."
my DH also had Glaucomo for several years...was on eye drop, Xalatan at night....it was a real problem toward the end, trying to put them in his eyes..wonder if there is a connection between AD and Glaucomo
My husband also has glaucoma. He's early enough in AD that he's still putting in his own drops, but I've wondered if I'd be able to do it later. It doesn't sound as if it's going to be easy!
Last night hb said, "Okay, I guess I'll let you do it; but I hate it." He squints so tight it's really hard to make sure a drop gets in his eye. Hope he continues to let me try.
I have a question...is there any outward look to an eye which has glacoma? Now and then I think my DH's eye looks sort of well buggy eyes or a bit to big..the eyeball that is.And his eyes seem a tad bloodshot now and then ( no not from drink LOL). His mother and two sisters have this condition. One sister does not have AD.
My DH has severe glaucoma in one eye. He's lost most of his peripheral vision due to it. He's always fought me on the drops (2 each morning and 4 each evening -- with at least 5 minutes in between each). Lately, I think due to the addition of Lexapro, he's more willing to let me put them in. I do not believe there is any outward manifestation of glaucoma -- that's why it's so dangerous.
There is a thyroid condition that can cause a bulging of the eyes: Graves' ophthalmopathy
In Graves' ophthalmopathy, your eyeballs bulge out past their protective orbit (exophthalmos). This occurs as tissues and muscles behind your eyes swell and cause your eyeballs to move forward.
There is no difference in the appearance of the eye with glaucoma, I have glaucoma, use the Xalatan drops each night, just now put them in, hope this does not mean I will have Alzheimer. Many people have glaucoma, does not mean you will go blind, when the high pressure is caught early. Mine was found in the early stages, I am what they call at risk for glaucoma and the Doctor says I will never go blind or loose my vision because it was found so early. Everyone should have yearly eye exams, I had no problems. I wear no glasses my visison is 20/20 in both eyes and would have never known I had high pressure except for yearly eye exams.
Last yr during our eye exams, we were both told we have signs of glaucoma and just to make sure we get eye exams every year. My husband sees very well. It is the seeing and making sense to the brain that is the problem. Sometimes I feel like I am with a blind person but then he sees the speck on the floor or counter.