Eye Pressure and Emotions

As I mentioned in my previous blog post, I've found a definite eye pressure-emotions correlation in my own experience. That's what I'll be sharing in this entry:

After my diagnosis on the basis of eye pressures of 28 and 29, I started a regimen of two different eyedrops, each used twice a day. Over the next few months, my pressures varied with an average of about 3 points lower than at my initial appointment. I was still very nervous before and during having my pressures checked, but not at the level of my first appointment. So, I wonder what effect, if any, the drops were having. For that matter, I wondered then. I even asked the doctor if stress affected pressures. He answered that it didn't. Over the next six years, my pressures were typically in the mid 20's range with very few excursions into the lower 20's. Unfortunately, I didn't document my experience in as much detail during the first few years, so I can't make a clear IOP-emotion connection that later became so evident.

 About six years later, I moved out of the state and transferred to another doctor. My pressures were much the same as they had been in previous years. And I was still just as nervous at appointments. One particular appointment, though, brought about an epiphany in terms of what might really be going on with my pressures. On the day of my appointment, I was feeling somewhat under par. Just as I began to sit up in the chair to have my IOP checked, I felt a little "off" and told the doctor. I leaned back for a few seconds until I felt better, and then he took my pressure. It was 8! He attributed it to how I was feeling and said that it would go back up in a few minutes. So, I waited for awhile before having my pressure checked again before I left. At this point, I was feeling better than fine. I was not only relaxed, but as relieved as I had ever been just to know that my IOP could go as low as 8. So, I felt no pressure, so to speak, waiting for the second reading. I just assumed it would be the usual mid 20's, but I was basking in that IOP of 8 and still was as my second pressure reading was taken. The second reading, the one that was supposed to be back to "normal", was only 14. The doctor didn't seem to have an explanation for this. Neither did I! At least I didn't at that time.

Now, I attribute it to what was probably a dramatic change in venous pressure which might have had a physical component, but most definitely had an emotional component. This historic IOP of 14 was taken while I was in a completely unstressed, happy state of mind. For that to happen during a pressure check was a first for me - and so was that IOP of 14.

The next four years with another doctor began to reveal more about the connection between my IOP and my emotions.

 During the first two years, my IOPs were about a point lower on average from previous years. That was despite the discontinuation of one medication.

The next year was an emotionally stressful one and I don't believe it was a coincidence that my IOPs were up by three points. Unfortunately, stress wasn't factored into things and my medication was changed. After a crisis with a beloved pet and another health crisis in my family in the same week, my highest pressure before or since then was recorded at 33 and 34. I firmly believe - now - that the acute stress I was experiencing in general at the time exascerbated by my usual anxiety during eye exams was mostly, if not solely, responsible. At that point, though, there wasn't enough evidence of my pressure-emotion connection. So, my eyedrop protocol was changed from one drop to another once again. This time, though, I had a severe allergic reaction and had to discontinue eyedrops altogether for a few weeks. On top of that, I was placed on a steroid to reduce the swelling of my eyelids.

Despite all of this working against me, my pressures, which were taken more frequently during this time, were several points lower than they were when it was only my emotions working against me. After the "dust settled", my optic nerves were pronounced to still be in perfect condition. At this point, I was placed back on the original medication that I had shown I could tolerate.

At this point, I was back to a relatively calm life. I also felt less apprehension at my next two appointments because of what I had weathered several months earlier. I don't believe that it's a coincidence that both pressure checks (several months apart) were the lowest two recorded IOPs of the past four years.

After moving to another city, I saw another doctor for pressure checks. (She also checked my optic nerve, but I planned to see my previous doctor for an optic nerve check as well.) It was over the course of the next three years that I began seeing stark contrasts between my pressures in relatively relaxed situations versus anxious ones. (I was having them checked more frequently now as I was seeing factors influencing my IOPs that weren't related to medication.)

Despite the change from Epifrin to Alphagan, there was no significant change in pressure. They still ran mostly in the lower to mid 20s. The doctor wanted them lower. So, I was given a prescription for Trusopt to be added to Alphagan which I was now taking three times a day. Because of my previous experiences with medication changes, I was uncomfortable with this. It was at these pressures that my previous doctor had dropped a medication with no increase in my pressure. So, I continued with the Alphagan and looked for another doctor. Her attitude was negative regarding my pressures and my appointments over the next few months were tense. My pressures were in the mid 20s. I knew it was only a matter of time before she would insist I add a medication, too. I was also becoming more and more aware of how stress could affect IOP readings. So, I looked for yet another doctor.

Actually I found two for pressure checks only. Because of the undeniable correlations I was finding, I wanted to minimize any other possible variables such as callibration of equipment. This time I made sure that both doctors had an attitude that was conducive to my having a more relaxed emotional state during pressure checks. During the next year, my pressures were consistently between 16 and 21. Every single reading was lower than any of my recorded pressures in the past 20 years.

Following a family emergency, a move, and other life changes, my stress level rose again along with my eye pressure. It was back to the mid 20's with the highest of about 26. I was determined to reverse this. When I returned a few months later for a checkup, I asked the receptionist if it would be at least 20 minutes before my appointment. She said yes. I told her that I was going to walk around outside for a few minutes. So, I had a brief but leisurely walk, let my mind wander, and went to a different place with my emotions. My IOP that day was 16, one of the three lowest eye pressure recordings I've had in my 30 year history.

I suspect that the emotion-eye pressure correlation varies from person to person and it may be even stronger with some than it is with me. It's also my belief that even slight emotional changes can produce IOP changes. The challenge is, at the risk of making a terrible cliche', "being in tune with your emotions". It's true, though, and I'm not sure it's even possible in terms of detecting subtle changes. That's all the more reason to be able to frequently monitor your IOP -- if you can. But that's another post!