I have been seen by two doctors. Both say I have glaucoma. I would like to know what the devil this is because both doctors said to use Xalatan at bedtime for the rest of my life.

DEAR READER: Glaucoma is a group of diseases that damage the optic nerve in the eye(s) that results in diminished vision, leading to blindness. The light-sensitive optic nerve connects the retina to the brain, transmitting visual information.

There are different forms of the disorder, but the most common is known as open-angle glaucoma. The front of the eye has a space known as the anterior chamber, through which a clear fluid flows, nourishing surrounding tissues. The fluid leaves the anterior chamber and flows through a drain area and leaves the eye. There are times, however, when it passes too slowly through this drain, resulting in a buildup of fluid. The buildup of pressure that results can damage the optic nerve, resulting in open-angle glaucoma and may lead to a loss of vision. It should be noted that an increase in eye pressure is not an indication a person has glaucoma. Rather, it indicates a person is at risk for glaucoma. Then there is the diagnosis of glaucoma without an increase in pressure. This is slightly less common but is known as low or normal-tension glaucoma. Some people are able to withstand higher eye pressure than others. It all depends on how much pressure your optic nerve can handle.

The key is early detection. Eye exams should be performed by an ophthalmologist or optometrist every three to four years for Caucasians and two to four years for African-Americans aged 20 to 39, every two to four years for both races aged 40 to 64, and every one to two years for both races aged 65 and older. Under ordinary circumstances, if a person follows these timelines, visual abnormalities can be corrected and treated early. If glaucoma is discovered, medication in the form of eyedrops or pills can be prescribed to either lower the pressure or cause the eye to make less fluid. It may be necessary to take the prescribed medication several times a day. If you experience burning, stinging or redness, advise your prescribing specialist, who can make a modification.

It is important to understand that glaucoma often has no symptoms, and you may be inclined to discontinue your medication. Continued use is extremely important. The purpose of the medication is to either lower the production of fluid or to reduce the pressure of the fluid.

The Xalatan drops you have been prescribed will reduce the pressure in your eye(s). You should wash your hands before and after use. The medication should be taken in the evening unless your doctor provides other instructions. You may experience blurred vision, and your eyes may become sensitive to light. Refrain from driving or doing detailed work until you determine whether you experience any unwanted side effects. Never use more than the recommended dose.

It appears both physicians you consulted are in agreement. My guess is the Xalatan is a completely appropriate recommendation that you should follow. Many people your age are on more medications every day than I have fingers and toes. You’re one of the fortunate ones that have reached the age of 78 without a plethora of problems.

To provide related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.