Don's Blog - All Comments

re: My SLT Laser Surgery Experience

tsingle999 — Thu, 09 Oct 2008 18:34:50 GMT

Hey Don I am glad you are getting good result. i had the procedure done and i had a problem when the doctor did my right eye. I guess there wasn't enough pain killer in the eye and every shot was increasingly giving me the worst headache right in the middle of my eyeball until i couldnt take it and moved out. The left eye was done fine. I did not have much change in pressures. I would recommend doing 1 eye one day and the other eye at a later date in case there are complications. Best wishes, Taran

re: My SLT Laser Surgery Experience

Dave — Sat, 20 Sep 2008 21:48:07 GMT

Don - congratulations on the successful early results and I wish you the best long term results. I am very happy you posted your experiences here.

I am very interested in following your IOP over the next 6 weeks and beyond. I look forward to hearing more. Thanks

re: Follow up Doctor's Visit

dsaito — Fri, 19 Sep 2008 00:05:12 GMT

Wow, that is a big difference. Will keep this in mind! I have a nightstand next to my bed. I can place it there.

re: Follow up Doctor's Visit

Dave — Fri, 05 Sep 2008 20:04:03 GMT

Don - in my experience, intraocular pressure can change by up to 10mmHg by getting out of bed and walking to another room. Just keep that in mind. If you really want to get a better idea of your eye pressure at the moment you wake up, the tonometer needs to be positioned by your bed. You need to take your IOP without standing up -- ideally, even without getting fully awake.

re: Follow up Doctor's Visit

dsaito — Fri, 05 Sep 2008 18:48:38 GMT

Dave, to answer your question, I typically, get up and go to another room to test my pressure after waking. It is a few steps away and I realize, the pressure may lower a bit from doing this.

Tsingle999, thanks for the info.

re: Follow up Doctor's Visit

tsingle999 — Fri, 05 Sep 2008 16:06:54 GMT

Don, very informative post. i think that is exactly what is going on with me. i have sleep apnea and low blood pressure as well which does nerve damage too. i have started using a dental device (mouthpiece) for sleep apnea and am taking eleuthro and ashwaganda for blood pressure. i am going to look into the AC carbamide for myself. i would get checked for sleep apnea if you snore at all...

re: Follow up Doctor's Visit

Dave — Tue, 02 Sep 2008 04:51:01 GMT

Don - very informative update. And thanks for the feedback on the AC Carbamide. Your white coat ocular hypertension is very similar to what I have seen from other people. How do you test your eye pressure after waking up in the morning?

For your situation, it is probably best if the AT555 is right beside your bed so that you can test within seconds of raising your head off the pillow (and without standing up and walking).

Let me know if I can help.

re: Doctor's Visit Eye Pressure

Dave — Sun, 31 Aug 2008 17:33:29 GMT

I have heard from others who follow this advice and take their eye drops before getting up (even in the middle of the night). They use a variety of different eye drops. Check with your doctor for specific recommendations. Dr. Ritch usually answers emails for his patients. If you want his email address, I can provide it.

re: Doctor's Visit Eye Pressure

swan48 — Sun, 31 Aug 2008 02:06:17 GMT

Is it, just, timolol that is recommended (I have severe adverse reacations to timolol) or can it be any of your meds. that you can take before actually awaking to start your day?

Grace

re: Doctor's Visit Eye Pressure

tsingle999 — Wed, 18 Jun 2008 17:35:39 GMT

Dr. Ritch recommends (if your taking timolol) to take it as soon as you wake up or even when you get up to pee before you actually wake up to combat that early morning rise.

re: Doctor's Visit Eye Pressure

dsaito — Thu, 05 Jun 2008 23:49:13 GMT

Thanks for the feedback Dave and Amanda.

Dave, to answer your question - I currently do not have equipment to measure my IOP lying down since all I have is the AT555.

I agree with your comment on doing a month of early morning measurements.

I believe that circulation has a lot to do with eye pressure and increased circulation (from exercise) has a lot to do with the immediate relief of pressure.

My wife who has normal pressures tests at about 13-14-15 upon waking. Convincing her to get air blown in her eyes in the morning is quite difficult. If I can someone get my pressures in the same range with her, I would do several cartwheels.

re: Doctor's Visit Eye Pressure

Dave — Thu, 05 Jun 2008 23:24:09 GMT

That's good data and it confirms many of the things others are seeing.

The higher morning IOP values are very common. In fact, it is normal for IOP to be higher in the early morning hours and it is also normal for it to be higher while lying down. If I had to give an average based on the people I communicate with, off the top of my head I would say an IOP value around 20 upon arising and 12-13 at bedtime would be it. This is what glaucoma patients who are considered "well-controlled" by their doctors are reporting to me. Again, this is a very "seat of the pants" average I'm throwing out.

My advice (caveat: I'm not a doctor and I can't give medical advice) would be to monitor your morning IOP closely for a while before making any conclusions or changes in your routines/medications. And, of course, work closely with your doctor regarding any medication changes.

Early morning IOP values of 20 or less, if they reflect your maximum IOP, would not be bad for manyt people (as a general statement).

Have you thought about a way to check IOP accurately while lying down? Some people, including me, have done it with your model tonometer, but I do not know how accurate it is because obtaining the measurement surely induces some artifacts.

Why are your early morning IOP values trending from 18 to above 20 in some of your data? Is it a temporary "artifact" related to postural changes (getting out of bed) or is it an artifact related to measuring your IOP? (Any anxiety or concern about your IOP could impact your IOP.) If it were me, I would want a month of really good early morning IOP data before I began considering the interpretation of that data. Pay attention to every detail including how you wake up and your mental/emotional state.

Even the act of sitting up in bed can change your IOP within one minute. There is a bunch of stuff on my blog about posture and IOP. Here is one example:

fiteyes.com/.../Postural-Changes-and-IOP

Note that most of the data in the graph is taken over a period of about 2 minutes.

re: Doctor's Visit Eye Pressure

Amanda — Thu, 05 Jun 2008 23:13:06 GMT

I like your sense of humor. You made me laugh out loud with that last sentence. But your points are well taken. Thanks for the informative post.