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Blocking TNF-alpha function may have a benefit as a neuroprotective treatment ... 

Tue Dec 5 2006

I was told, "Nice photos. I would like to use them in a lecture. Your left disc has some thinning of the rim superiorly. You could get a GDx-VCC and see what it shows."

I did get the GDx-VCC and I posted the  GDx-VCC test results here. I also have Heidelberg Retina Tomograph test results posted and you can find them by using the HRT tag.

This is some very scary news from MedIndia.com:

The Assam government Friday ordered a judicial probe to investigate a botched cataract surgery camp at the Guwahati Medical College in which 38 people were blinded.

Health Minister Himanta Biswa Sarma said the enquiry would be conducted by a retired judge of the Gauhati High Court and was expected to submit the report in three months.

Records of 93 consecutive glaucoma patients (185 eyes) who underwent sequential office intraocular pressure (IOP) measurements (every hour from 7 a.m. to 5 p.m. on a single day) were evaluated to determine the usefulness of day-long sequential office measurements of IOP to make therapeutic decisions in patients with progressive glaucomatous damage despite apparently "controlled" IOP.

 A friend referred me to a new ophthalmologist who lives in another city. I corresponded with this new ophthalmologist via email. I am not replacing my current ophthalmologists, merely seeking additional input on specific issues where experts are few and far between.

However, I guess many facts did not get communicated clearly in my various emails to the doctor. The doctor sent me this email reply today (and I edited what is posted here):

Probably the most interesting thing about today's data is the series of measurements behind the IOP value at 19:20 (7:20 PM) for my right eye.                                                                           &nbsp

I had certain expectations for my IOP values today. I expected the values to be lower in my right eye. I thought I had done the same things I did around the period of November 10th or 11th. On those days (and some preceding days), my IOP in my right eye was closer to 15. It may be that the difference in IOP is related to my schedule for using Timoptic in my right eye, or it may be due to something else I have not noticed. What I am sure of is that I can adjust things to get my IOP back down to 15 without too much difficulty.

Today's Lesson: It requires both medication and lifestyle to fully control my IOP. Either one alone is not enough right now. This is the middle way. I would like to control my IOP without medication (or even without Timoptic), but attempting that right now would be too extreme. (I have a tendency to go to the extreme, and that's most likely a subtle personality factor underlying my glaucoma.)

 Today was not a typical day! For one thing, we took 200 IOP measurements today! For another thing, my IOP values were not well controlled. It was like my emotions were directly connected to my IOP today, and my emotions were varied. Consequently, today's data shows a large range from the maximum value to the minimum value. That range is 16.7, way above yesterday's value of 11 (which itself was above previous values of 9-10).

 Today's values seem to show that when I stop thinking about business (or other financial issues), my IOP is lower.

Today's overall averages are:

Left 15.2; Right 15.2 (differential 0)

The differential is going in the opposite direction from what I have seen in the past. Normally, it increases slightly with each extra day since the last time I used Timoptic in my right eye. It has now been 6 days since I used Timoptic and things are looking good.

Sometimes I like to think that my blog will be useful in some small way and that it might spur researchers to look at intraocular pressure in new ways. However, I also understand that I'm biased -- and that it's impossible to remove all this bias from the IOP data we're collecting because of the design of this project. This bias probably limits the conclusions that can be drawn from the data. Experienced researchers understand the issue completely, so I'm not writing this to explain it to them.

I didn't sleep enough last night, and I felt a little dull today. Consequently, I just went through the motions in most of my activities today without pushing myself very hard -- and without putting much effort into the positive habits I've been developing, either. For example, I did not do any weight training today, nor did I  accomplish anything  extraordinary at work. I didn't get to cross off many items on my ToDo list.

Today my eye pressure was about perfect. Here are the overall averages:

Left 15.1; Right 13.7 (differential -1.4)

Something changed between yesterday and today...

In recent weeks my eye pressure has been higher, on average. I presume that situation coincides with the meetings and discussions about my new business venture. We had casual conversations for a while, but the beginning of serious meetings and we financial negotiations, correlates closely with the increased average eye pressure values. (Of course, there could be something else that changed around this time that I'm overlooking, so I'll try to keep an open mind.)

As I write this, my blog is not online. I expect that by the time you are reading this, there will be entries preceding this one as well as following this one. However, I do not expect to have posted daily IOP reports for every day since July 7, 2006 when we began this project.

There are a few interesting comments I can make about today's IOP data. First, the weight-lifting effect is present once again. Second, notice how watching "The Amazing Race" on TV raised my IOP. I can't really explain that, but I have seen the same thing happen so many times that I don't believe it is a coincidence. Watching the news, particularly when there is a lot of bad news, has a similar IOP-raising effect on me.

Today's overall average IOP values are:

Left 16.7; Right 19.4 (differential 2.7)