Ophthalmology & Optometry/vertigo & Headache

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Question
Dear Sir,
In Aug.2005,NA Glaucoma was Diagnosed & since drops couldn't control IOP,Laser surgery was performed in Dec.2005.
Then in Mar/April2011,Phaco was perfromed.IOP in BEs is 14/16mmhg without any eye drops,so far!
In June,2014,I had watering from RE & repetitive infection occured.In May 2015,Abscess caused blockage of CanalIcular resulting in swelling & pain.
Plasic Surgeon performed surgery on 20th.to clear blockge & sincethen NO watering takes place.
I am fine with Vison with powered glasses.
Since 21st.Sept.I have severe haedache & vertigo.My BP is 120/80mmhg.on 25th.I take BP drugs since last 4years,as precaution, to combat against dialostic pressure monitored as 95/100mmhg.
I would also like to know whether there is any corelation between BP & Ocular perfusion pressure?
I read Ocular perfusion pressure in the eye,may cause some damage to optic nerves in Glaucoma patient.
Since I am on BP drugs-Atenolol-25mg & Amlodipine-2.5mg since last 4 years,does it make sense to result lower Ocular perfusion pressure for Headache/vertigo(when I get up from Lying position Only).
I don't know,how ocular pressure is measured,as my Ophthalmologist never checked so far.
Is there any other way to assess eye condition to overcome issue of headache.
Kindly respond as Physician is unable to ascertain the reason,except to prescribe Crocin-which gives temporary relief.
Thanking you.
with warm regards,"

Answer
Anil,
Headache and vertigo are very unlikely related to any eye condition.
Ocular pressure, more correctly - intraocular pressure, is typically measured with goldmann applanation tonometry- a common standard of eye care. See the below link for information...
http://eyewiki.aao.org/IOP_and_Tonometry
If you are being managed for glaucoma, they have surely done a test like this on you in the past.
Ocular perfusion is the dynamic between eye pressure and blood pressure - if the eye pressure is too high, or the blood pressure is too low, the balance is off and the optic nerve can have damage (glaucoma).
It sounds like you may need an ear or neurology consultation for the vertigo, I may talk to you doctor about options.
Good Luck!
Dr.D

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John M. Dovie, OD, FAAO

Expertise

As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.

Experience

Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

Organizations
American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

Publications
Seminars/Presentations:
“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
Publications:
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Education/Credentials
Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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