Blogs

From "Review of Ophthalmology":

Most human IOP measurements are “snapshot” measurements—a single reading taken periodically in a doctor’s office. Any conclusions about the nature and impact of fluctuation have therefore been largely based on very sketchy evidence. Read more...

Trabecular Meshwork Cell (detail)

This is the winning image for North America -- IN Cell Image Competition. It shows the internal structure of a single trabecular meshwork cell.

In this image, DNA has been stained blue, so the large clumps of blue just above centre are the cell's nucleus. Red lines are filaments of actin spread throughout the cell, while the green patches at their tips are the focal adhesions.

In my opinion, the two facts listed below are the most important facts you need to understand about glaucoma.  

This is from an email conversation between me and an ophthalmologist on the topic of research data.

Me:  In our self-tonometry research, we perform frequent eye pressure monitoring throughout the day. The testing needs to be quick and convenient. If the testing takes too long, it will interfere with our ability to collect frequent measurements. The larger number of measurements helps answer questions we could not otherwise answer and it also eliminates some concerns regarding reliability of the data.

In a recent discussion on the FitEyes email discussion list we had an interesting exchange about allergies to the glaucoma eye drops. If you want to see how serious this can be, one picture is worth a lot of words:

On Fri, May 20, 2011 at 7:39 PM, a FitEyes member wrote to the discussion list:

But at my doc's suggestion I decided to tolerate the side effects of alphagan . It took almost a month but the extreme swelling itchiness redness and tearing all disappeared completely. I think your body adjusts to the allergies over time

The fact that the most obvious allergic symptoms subside does not necessarily mean that the body has entered a balanced state where the immune system reaction to the eye drops is now normal and healthy (i.e., non-allergic). In many cases, it simply means that the obvious reactions are now suppressed.

In some, but not all, cases the issue that was causing the original allergic reaction remains active in the physiology. But now the manifestation of that problem is less obvious. But it is in fact manifesting somewhere, somehow, in the body.

That does not have to be the case. But in my opinion, the issue is whether we did something to foster balance so that the body could adopt a healthy relationship with the eye drops or whether we did everything we could to suppress the symptoms without actually creating a balanced and healthy inner state.

In my experience, emotions are the key to this. I'll explain this in more detail below.

For those of us with glaucoma or ocular hypertension, our goal is for the fluid in the eye (aqeous humor) to be able to flow freely out the two exit pathways from the eye. In this context, we had a recent discussion on the benefits of fish oil and DHA for glaucoma. In this discussion, someone raised this point:

Quote: "fish oil can improve membrane permeability"

That's a useful fact on its own. But that got me thinking about what I have learned from teaching and practicing Serene Impulse (and doing so as both a glaucoma patient and a personal self-tonometry researcher).

Fish oils (including DHA) may have a small effect on IOP -- but much less of an effect than other things I have identifed as a result of mixing self-tonometry and Serene Impulse -- and also as a result of interacting with other tonometer owners in the FitEyes community.

In pursuing knowledge that will help me manage glaucoma, I have a guiding principle: don't waste your time going after the small change. Go for the stuff with the big payoff. Mental and emotional tension, which always lead to tissue contraction, are a key area where we can find that big payoff. For some background, please see this link:

http://fiteyes.com/blog/dave/the-two-most-important-facts-you-should-know-about-glaucoma

And here's another related post by Bailey:

http://fiteyes.com/blog/bstruss/mental-emotional-and-lifestyle-factors-are-the-powerful-iop-influencers

And I will expand on all of this in the present article and tie it together into an (informal) theory of elevated intraocular pressure.

I think the following list represents some of the most informative and useful articles on FitEyes.com. There are thousands of articles on FitEyes.com, so many good ones will not be on this list. But this list is a good place to start reading if you are new to FitEyes.com. If you are not new to our site, please make sure you have seen these articles.

Please feel welcome to add comments to this post to mention your own favorite articles on FitEyes.com.

After obtaining the Reichert 7CR and understand my eyes response to different situations, times of day and other stimuli, this first set of result is very encouraging for me after this small changes I have made.

Since I am the type of person using the left-brain, as is described in this post, as part of several tests performed simultaneously I eliminate caffeine from my diet in all its forms.

http://fiteyes.com/mistake-of-the-intellect

I am learning so much more about these patterns and their effect on my IOP all the time. Recently, I had a major emotional crises with my family concerning a simple misunderstanding and lack of communication. Interestingly, my eye pressures did not rise in the first couple of days (though the stress was off the charts). However, after a couple of days, my eye pressures went crazy, and even with lumigan, I could hardly get them below 20s.

I have had my tonometer for almost 6 months.  It has answered a multitude of questions about how my daily routine affects my health.  I didn't know, for example, that just taking a walk outside for a half hour or so would reduce my eye pressure, sometimes by as much as 50%.  I also didn't know that I wasn't one of the people whose pressures are higher at night--in fact my lowest pressures are at night.  (That was good news.  I was tired of sleeping with my head elevated).  

I have found no supplements that had any effect on lowering my IOP, but I have found that some supplements will raise my IOP quite significantly.  I know that out of control thoughts and periods of stress significantly raise my IOP in spite of the two drops I am using or any other healthy lifestyle choices I am making. 

Read more...

UPDATE: You have to purchase a tonometer directly through your doctor. As of mid-2011, tonometers are not aprpoved for home use in the USA yet. That is coming. However, you can still get a tonometer now. Doctors are allowed to prescribe medications and equipment for off-label use, so it is not a problem for your doctor that tonometers are not approved for home use. However, manufacturers and distributors of medical devices cannot recommend or sell a device for off-label use. That means you have to go to your doctor, not to a tonometer distributor.

For those of you who have been thinking about joining our self-tonometry program and purchasing a tonometer, I want to share a few details about buying a tonometer.

First of all, from the bottom of my heart, I have to thank Dave for leading me to my purchase of my tonometer; what a fantastic instrument!

Several years ago, my ophthalmologist said that I probably had what is called "normal pressure" glaucoma; my pressure was usually 15-16 whenever he checked me, and the highest he ever recorded was 19 on my right eye. He told me to find a glaucoma specialist, so I did.

I went to the specialist for a couple of years, but several things discouraged me from continuing to see him. I found another ophthalmologist; she was somewhat younger and, I thought, perhaps less apt to be running a Speede Oil Change type of service, to see how many people she could get through her clinic in a day. She was a bit better at the latter, but she refused to give me a prescription for a tonometer. I left her and quickly acquired a tonometer prescription; and by the way, the requirement for a prescription for a non-contact tonometer is as silly as the need for me to have a real estate broker's license to sell real estate, or for a city to have building inspectors.

In any tonometer (based on today's technology), you can have some, but not all of, the following:

• ease of use
• accuracy (reliability and validity of data)
• low cost
• portability

People tend to give a priority to portability and low cost. New products aimed at this feature set have recently been announced. Does it make sense to utilize those devices for self-tonometry?

We have to agree that any trade off that doesn't include reliability and validity of IOP data invalidates the whole endeavor of self-tonometry. Not only is it meaningless to do it if the data is not of sufficient quality upon which to make important decisions, but it could actually be detrimental to do self-tonometry in that case.

With today's technologies, portability entails user-alignment (in the context of self-tonometry). Proper user-alignment to produce a valid measurement, by definition, depends upon user skill as well as various specific conditions of each measurement. User-alignment, regardless of the tonometer, is difficult! (User-alignment is defined as the operator of the tonometer having to align the tonometer with the eye manually. Alignment is a very precise process requiring a steady hand, good eyesight, training and practice.)

Therefore, the requirement of user-alignment conflicts with the requirement of reliability and validity of IOP data. We cannot guarantee reliability and validity of IOP data when variable user skills are required to produce that data.

If any decent ophthalmologist or scientist (or intelligent thinker) considers a set of IOP data, they must consider how the data was obtained. If patient skill played a critical role in producing that data, as it does when user-alignment is required, the clear thinking person will immediately discount that data. Therefore, the self-tonometrist's efforts may not produce much of value.

Leading Medical Specialists Support Self-Monitoring of Eye Pressure by Glaucoma Patients;

Self-tonometry has Potential to Transform Glaucoma Treatment, Says Co-Author of Recent Journal Article

Growing recognition among leading ophthalmologists and glaucoma specialists of an alternative option for measuring pressure in the eye may offer new hope for four million Americans – and millions more people worldwide – who risk permanent blindness, says a co-author of a recent article in the Survey of Ophthalmology.

Millions of people around the world should be monitoring their eye pressure (intraocular pressure) at home, according to health organizations (such as  International Society for Self-Tonometry (ISST)) that are issuing recommendations on what to do and how to do it. Many experts, such as Dr. Graham Lee, feel the evidence is quite strong that home eye pressure monitoring leads to better control of intraocular pressure, and the evidence is quite strong that intraocular pressure control lowers the risk of glaucoma progression and optic nerve cell death.