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Ask questions to get answers about glaucoma

Dear Dr. Gott: Last year, during my yearly eye examination, my doctor asked me if I had poked my eye with a stick (which I hadn't), because I had a line in my eye, which was a first sign of glaucoma. He also noted that I had some pigment on both of my lenses.

Could you tell me if there is any treatment for this condition? My doctor didn't tell me if anything could be done. Should I get a second opinion?

Reply: Let me start by saying that if you don't ask questions, your doctor can't answer them. If there was something you didn't understand or simply wanted to know more about, you should have said so. Doctors aren't mind readers.

Unless the patient says otherwise, the physician assumes the information has been understood. I have said time and again that people who take active roles in their health will usually get the best care.

Now, to your problem. Pigment is the substance that gives our eyes colour. Sometimes, this pigment can flake off and land on other places, such as the lens. It often goes unnoticed, as it doesn't cause symptoms.

I believe your doctor was referring to a rare form of glaucoma called pigmentary glaucoma. This condition results when pigment flakes off the iris and blocks the meshwork that allows for proper drainage within the eye. This increases the intraocular pressure, leading to damage to the optic nerve, better known as glaucoma.

If your eye pressures had been increased, you likely would have been told so and given steps or medications to take to reduce the pressure and prevent further damage. In your case, if the pigment is only on the lens, it is probably not blocking the meshwork. Return to your doctor and ask for clarification of the situation. If he or she refuses to elaborate, get a referral for a second opinion.

Dr. Gott is a retired physician and the author of "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook". Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.