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How to deal with Gulucoma. Pilocar 2% is not suited. It getting energy.
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Eye & Vision Disorders
Question #10451
286 days ago
394

How to deal with Gulucoma. Pilocar 2% is not suited. It getting energy. - #10451

Rajesh kumar

I got discover gulucoma in early stage in 2018. I used Rayprost, pilocar 2%. After using pilocarpine, it resulting elergies in eye. I must stop pilocar but eye pressure is increasing. Pls.suggest accordingly.

Age: 53
Chronic illnesses: High BP.
300 INR (~3.53 USD)
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Doctors' responses

Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
285 days ago
5

If IOP is still not controlled: Your ophthalmologist may consider:

Brimonidine (Alphagan P)

SLT (Selective Laser Trabeculoplasty) – effective for early glaucoma

Surgical options if all else fails (e.g., trabeculectomy)

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Dr. Neeraj Agarwal
I’m an MBBS graduate with a deep commitment to providing meaningful, patient-first care. My clinical training has given me a solid understanding of how to assess and manage a wide variety of health conditions—both common and complex. But beyond just clinical skills, I’ve always believed that the heart of medicine lies in listening. That’s what I try to bring into every consultation: not just treatment, but genuine attention to the person in front of me. I have gained experience across general medicine, paediatrics, emergency care and preventive health. I have treated patients of different age groups and backgrounds, which has helped shaped a more flexible, to diagnosis and management. Whether someone comes with a new symptom or a routine check-up, I aim to deliver evidence-based treatment, explained clearly and tailored to the lifestyle. I’m especially focused on making care accessible and comfortable. Too often, patients feel rushed or confused when they leave a doctor’s office—I try to do the opposite. Taking time to explain options, risks, or even just what’s going on in simple terms is something I take seriously. Communication, I think, is just as important as any prescription. I actively stay updated with current medical guidelines and research, and I’ve been exploring areas of holistic care and preventive medicine too. The more we can do to catch problems early—or better yet, avoid them—the better the outcome for everyone. I’ve seen how small lifestyle changes, when supported properly, can make a big difference to long-term health. There’s still a lot to learn, of course. I think every good doctor keeps learning. But every patient I see teaches me something new, and I carry those lessons forward—with honesty, empathy, and the intent to keep improving.
285 days ago
5

You can continue rayprost and discontinue pilocarpine due to allergy Start eye drop Timolol + Brimonidine 2 drop thrice day Also get checked Visual fields & OCT test: Every 6–12 months to monitor progression. IOP monitoring: Recheck 1–2 weeks after switching or adding meds. Ecg to check for any heart condition

U can opt for surgery if continue facing increased iop

545 answered questions
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Dr. Alan Reji
I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.
285 days ago
5

Since pilocarpine caused allergies and your eye pressure is rising, you may need alternative medications like beta-blockers (e.g., timolol), carbonic anhydrase inhibitors, or selective alpha agonists. Rayprost (latanoprost) is effective, but combination therapy is often needed to control glaucoma progression. Consult your ophthalmologist promptly to adjust your treatment and prevent vision loss.

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Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
285 days ago
5

Continue: Rayprost (Travoprost / Latanoprost) 1 drop at night in both eyes (Prostaglandin analog – first-line agent) Discontinue: Pilocar (Pilocarpine 2%) – due to allergy

Dorzolamide 2% eye drops 1 drop in both eyes twice daily (Effective with fewer systemic side effects)

1930 answered questions
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Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
285 days ago
5

Monitoring Plan: IOP check every 2–3 months

Visual field testing yearly

Optical Coherence Tomography (OCT) to assess optic nerve health

Ensure compliance with drops

Precautions: Use eye drops exactly as prescribed – spacing between different drops should be at least 5–10 minutes

Avoid rubbing eyes

Avoid overuse of topical steroids

Monitor BP regularly – some glaucoma meds (e.g., beta-blockers) may affect BP or pulse

1930 answered questions
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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
285 days ago
5

Hello dear Please be aware I think probably the infection is spreading fast You can take itone twice a day for 5 days I suggest you to please consult opthalmologist for confirmation Regards

2526 answered questions
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In your situation, where pilocarpine has caused allergic reactions and you need to manage increased eye pressure due to glaucoma, it’s crucial to consider alternative treatment options. Firstly, since pilocarpine isn’t suitable anymore, there are other classes of medications available for glaucoma that might be more appropriate for you. One common alternative is prostaglandin analogs like latanoprost or travoprost, which are effective in reducing intraocular pressure (IOP). These are usually applied once a day and have a different side effect profile compared to pilocarpine. Another category is beta-blockers, like timolol, which can also help lower IOP by reducing the production of fluid within the eye. Additionally, carbonic anhydrase inhibitors such as dorzolamide or brinzolamide can be useful if you’re looking for topical solutions. If these medications are unsuitable or insufficient, there are laser therapies like selective laser trabeculoplasty, which can be an option for managing eye pressure without the need for daily medication. In some cases, surgical interventions may be recommended if medications and laser therapies are ineffective. It’s essential to consult with an ophthalmologist to review your ongoing treatment regime comprehensively, considering your specific cause of increased eye pressure and personal preferences. They can guide you through the evaluation and trial of alternative medications, ensuring a tailored approach to management. Since glaucoma is progressive, it’s vital to address increasing eye pressure swiftly to prevent further vision loss. Always inform your eye specialist about other health conditions you may have or any other medications you’re taking to avoid interactions.

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