In 2011, Muir noticed that his vision wasn’t as sharp as it should be. As he and his wife were planning to travel to the UK and Europe later in the year, he decided to visit an optometrist to get new glasses. What he thought would be a routine check-up turned out to be the beginning of his Glaucoma journey.
During the examination, the optometrist identified that Muir’s intraocular pressures (IOP) were too high, particularly in his left eye. Without delay, Muir was referred to an experienced glaucoma sub-specialist ophthalmologist. They confirmed that Muir had glaucoma.
The relationship between Muir and his eye specialist has been one that’s full of trust and good-natured banter because he remembers him saying during his initial appointment, “as you are still a relatively young man (I was in my early 60’s at the time), this is probably going to be the beginning of a long association, because glaucoma is something that you monitor and treat on an ongoing basis rather something that you treat and make a full recovery.”
For the first couple of years, Muir managed his condition with a drop funded by Pharmac. The medication worked well and kept his eye pressure under control.
However, while he was travelling in the South of France in 2013, “my eyes became red, puffy and infected. It was like having an episode of conjunctivitis that I had had years before.”
Because he was away, it was difficult to seek medical treatment so, despite the discomfort, he continued using his prescribed drops.
To Muir, with his knowledge of the impact of glaucoma, he considered that stopping the medication was not an option. In any case he thought that it was an infection rather than a reaction to his prescribed glaucoma eye drops, a side effect he was unaware of at the time.
As soon as he got back to New Zealand, Muir went to see his eye specialist, who immediately said ‘Hmmm, I don’t think that you are suffering from conjunctivitis, I think that you have developed a reaction to the preservative in the drops funded by Pharmac, which I have been prescribing for you.”
His eye specialist took him off the Pharmac funded drops to confirm his diagnosis and prescribed some temporary alternative interim medication.
While ceasing using the Pharmac funded drops solved the drug reaction problem, a longer-term strategy needed to be developed for his ongoing glaucoma treatment, as the pressures in both eyes were still higher than his eye specialist was happy with.
The eye specialist recommended a surgical intervention—a Molteno Aqueous Tube Shunt Device insertion in Muir’s left eye, the one most affected by glaucoma. The procedure was successful and the pressure in his left eye has been stable ever since without the need to use eye drops.
As Muir’s right eye still needed ongoing treatment, he was prescribed a preservative-free drop not funded by Pharmac. As Pharmac funds a glaucoma drug, under the terms of Muir’s health insurance policy, this alternative preservative-free drug is not covered. He has no choice but to meet the cost himself as he fully appreciates that the drops are essential to protect the vision in his right eye. As he says the Pharmac funding model seems a bit strange in this regard. “If I was able to continue to use the Pharmac funded drops, the cost would accrue against the Pharmac budget but, because I can’t, the full cost of the alternative lies with me, not just the extra over cost (if any).” He appreciates that this Pharmac cost model applies to many other more expensive drugs used for treating all sorts of other diseases, so that altering it would likely have wider budgetary implications.
Using the preservative-free drops also requires a bit more planning, as he has to get it monthly. “I can no longer have multiple months supplies of the drops at home like I used to” he explained.
Alluding to a good relationship with his local pharmacist, Muir continued saying “When I rang the pharmacist recently, he said ‘I knew you’d be calling in the next few days, so I’ve just got some in.”
Reflecting on his journey, Muir realises how crucial early detection and treatment is. “I was just wanting some new glasses and they picked it up straight away” he said. “My pressure, particularly in my left eye, was very high and some irreversible damage had already been done by then, resulting in the loss of some peripheral vision in that eye”.
Muir’s family history offered little insight into his condition. Neither of his parents had glaucoma, but recently he found out that one of his cousins suffers from glaucoma. They speculated that it might have come from their shared side of the family but have no way of confirming it now. Muir has made sure that his family are aware of the potential risk.
“It is certainly something that you should tell your children and siblings. I’ve told mine. They are all aware that I suffer from glaucoma and that they need to get their eye pressures tested regularly” he said.
Muir is sharing his story, hoping that it will help others navigate their own journey following a glaucoma diagnosis. He recognises that the drops funded by Pharmac are the common starting point for glaucoma treatment.
Glaucoma is an extremely complex disease to diagnose and treat. Everybody’s experience will be different. Report any new symptoms to your eye specialist, or doctor, such as redness, irritation, itching, tearing, or decreased vision. Symptoms may be related to the disease, side effects, or complications of medication or surgery.
Glaucoma NZ is supporting a clinical trial that can help people like Muir, but it needs funding. Please consider donating towards it. Every little bit helps. You can donate here.