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Your doctor's intraocular pressure measurements are "very sketchy evidence"
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...
The two most important facts you should know about glaucoma
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.
The FitEyes Approach to Home Eye Pressure Monitoring is a Disruptive Innovation
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.
Glaucoma medication allergies, Serene Impulse and emotions
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
Would any of the alternative medicine practitioners in the FitEyes community like to comment on this?
I'm going to comment on it. You can consider this to be part two of a prior post I made which was entitled, "Glaucoma, elevated intraocular pressure, membrane permeability and emotions".
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.
Glaucoma, elevated intraocular pressure, membrane permeability and emotions
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:
And I will expand on all of this in the present article and tie it together into an (informal) theory of elevated intraocular pressure.
Who can we trust to provide good advice about natural glaucoma treatments?
The title of an article by Dr. Mercola caught my attention. He wrote an article on his website and entitled it, "Six Sure-Fire Tips to Prevent Glaucoma Naturally".
Let's examine Dr. Mercola's suggestions one by one and see if they are sound.
Some of my favorite articles on FitEyes.com
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.
How to Buy a Tonometer and Join FitEyes.com
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.
Are handheld or portable tonometers appropriate for home eye pressure monitoring?
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 From Around the World Coalesce Around Self-Tonometry
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.
Scientists Discover New Role for Vitamin C in the Eye and the Brain
Optic nerve cells require vitamin C in order to function properly. Henrique von Gersdorff, Ph.D., a senior scientist at OHSU's Vollum Institute and a co-author of a new study showing how essential vitamin C is in retinal nerve cells had this to say:
We found that cells in the retina need to be 'bathed' in relatively high doses of vitamin C, inside and out, to function properly.
These new findings could have implications for glaucoma. Glaucoma involves a dysfunction of nerve cells in the retina and brain that become over excited in part because GABA receptors may not be functioning properly.
Can any natural system of medicine -- homeopathy or naturopathy or other -- cure glaucoma?
When thinking about the fundamental principles of health, I have to wonder how effective any pill (homeopathic or vitamin or other) can be for a chronic disease like glaucoma that takes decades to develop.
In another thread on glaucoma, emotions, stress and NTG, Dr. Ritch said:
Pigmentary dispersion syndrome is associated with perfectionistic, detail-oriented, high stress people.
No herb or vitamin pill is going to change those traits. (Even psychiatric medicines won't fundamentally change them -- only suppress them, at best.) The research from psychoneuroimmunology (see Dr. Candace Pert's work) shows that these personality traits turn into biochemical molecules in the body -- powerful chemicals that are more potent and more abundant than most pharmaceutical medicines --- and that come in a endless supply day after day. We wake up every morning and never forget to put on our personality. When we do so, our body is flooded with the biochemical signature of that personality. Any pill we take does little more than put a small dent in that massive stream of internally manufactured biochemical compounds.
Think about that while reading this quote from a book by respected neurosurgeon Norman Shealy, M.D.**
Perhaps the best work in this field has been done by Dr. Caroline Thomas of Johns Hopkins Medical School. Her prospective studies of medical students have shown a high correlation with personality. Relatively specific personality quirks or defects predispose one to high blood pressure, tuberculosis, heart attack, cancer or suicide. These traits are present twenty to thirty or more years before the onset of disease. It appears that our “life script,” meaning our unconscious decisions regarding how our life will play itself out, provides a long-term attitudinal precursor of illness.
I wasn't familiar with that research in any detail, and I'm not relying upon it -- but this is essentially the same conclusion my own personal research on intraocular pressure led me to, and it is a core message of FitEyes because it conforms to time-tested principles of more than one traditional system of healing.
Here's the succinct way I like to state it (based on Ayurveda):
Consciousness structures the physiology.
Our habitual thought patterns, emotional patterns and lifestyle habits shape the form and function of the material structure of the body over time. We become physically who we are emotionally and psychologically. This is the most fundamental and powerful force shaping the development of any condition in the human body. Given that fact, how can we expect some little pill that we take to radically alter these long term trends?
Prudence, Horror and Intraocular Pressure
Recently we had a discussion on the FitEyes email list about experimenting with glaucoma medications. As part of that discussion, people expressed that they were horrified or fearful. At least one person responded by advocating a prudent stance. I certainly do not disagree with the advice given. In fact, I think everyone who responded to the original post was in agreement that the thing the original questioner contemplated was totally inappropriate for the person's skill level. So that was the end of that discussion, rightly so.
But what the emotional aspects of the discussion continue to intrigue me and I would like to go in a tangential direction with a new article drawing inspiration from that prior discussion.
Turn yourself into wine
This captures a lot of what glaucoma means to me. Iti captures my experience of the initial bitterness of glaucoma eventually becoming sweet. Glaucoma positively changed me to my core. Glaucoma has enriched my life beyond anything I could ever have imagined. By the way, Joanna Macy is worth reading.
Molecules that sense light can potentiallly restore human vision (been done in mice)
We can also, potentially, install light sensors onto the spare neurons in blind people, converting the spare neurons into a camera so they can send info to the brain. We've done this in mice.
Tell us about your tools.
The core idea is to take molecules that sense light and convert it into electrical energy, and put them in neurons. We can take a given class of brain cells and develop a virus to deliver genes to these cells. Then we can shine light on these cells and activate them and see what they do.
Altering Eye Pressure Without Medications
On the FitEyes email list we had an interesting discussion. I would like to share my response.
Here are my thoughts on this topic of altering IOP without medications:
How do I spend my day off? On FitEyes, of course!
Sometimes I wonder where all my time goes. I know I volunteer a lot of time to FitEyes that is unrelated to working with my clients or doing other things I "have" to do. So I did a quick check of where my time went on my recent "day off." Here's what it looked like:
1 hour emails (mostly related to FitEyes)
1 hour discussing new FitEyes website work with a developer
3 hours researching backup and storage solutions for the FitEyes website (long overdue)
1 hour to get a replacement computer part
1 hour enjoyable phone conversation with a FitEyes member
1 hour helping another FitEyes member with tonometer software questions
1 hour answering various emails from other FitEyes members
Tonometer in use!
I just received the email below. While I love these emails and each one makes me smile, this is a fairly typical response I see when someone receives their new Reichert tonometer. Keep in mind that the expectation from both of us is that we will have a telephone call when the person's new tonometer arrives and I will explain how to use it. The surprising result is that quite often I don't have to explain anything! That's how easy these Reichert tonometers are to use . This is true even for someone who is not good with technology.
Here's the email that just came today:
You should all listen to this Ivan Goldberg interview
This audio file contains an interesting interview with Dr. Ivan Goldberg (University of Sydney). Dr. Ritch recommends that we all listen to it.
Members of the FitEyes self-tonometry group should be regularly utilizing the water drinking test. See this message:
http://fiteyes.com/forum/water-drinking-test-for-glaucoma-and-self-tonometry-research-792
Research on how moods affect eye pressure
In an upcoming version of the FitEyes Insight software I hope to provide a very easy way to track moods along with eye pressure measurements. In preparation for that, I am working on a list of moods.
