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  • Q&A with Australian Health Practitioners

    Is there a link between tilted disc, myopia and very early onset NTG?

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    Glaucoma Myopia & Hyperopia (shortsightedness & farsightedness)
    Tilted disc causes weakness in the lamina cribrosa both superiorly and inferiorly which apparently is regionalised. Glaucoma in these regions even with normal IOP is, I guess, understandable. Could other areas which are not so anatomically disadvantaged in the eyes be affected or indeed be involved in progression? Also, could intense training on a cross trainer (HR > 90% predicted for 30 mins straight but no Valsalva or weight lifting) raise IOP? should I avoid this form of exercise altogether?
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  • Glaucoma Australia

    Glaucoma Australia is the peak glaucoma awareness/education/support association in Australia.It is a national, not-for-profit registered charity dedicated to providing educational services to raise awareness about … View Profile

    Myopia is a known risk factor for glaucoma irrespective of intraocular pressure (IOP). Myopic patients often have tilted optic discs and enlarged areas of atrophy (thinning) around the optic disc. These features of myopic discs make it harder to diagnose and monitor for glaucoma. The difficult question in early glaucoma in a myope is whether their visual field defect is from the disc tilt or from glaucoma. The only way of really knowing the answer is to perform monitoring over a period of time. If the defect worsens then it is glaucoma. If the defect remains stable then it is probably from the tilt and does not require treatment. Other areas of the optic disc can be involved, just like in glaucoma patients who do not have myopia or tilted discs. 

    Exercise is very good for general health and also for IOP, which drops significantly (average 4.5mmHg) after exercise. The higher the intensity, the more the IOP drops. This effect can be seen 3 weeks after ceasing exercise (established for 3 months) so the benefit will continue if you go on holidays for a few weeks without exercising. The trade-off is that exercise drops blood pressure and this could potentially cause reduced blood flow to the optic nerve at night when the blood pressure usually lowers. Exercise is encouraged, but moderation is always the key. 

    Weight lifting will raise the IOP significantly during the exercise, but it lowers straight afterwards by a small amount (1mmHg). 

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