What is Self-Tonometry?

 

All of us benefit from knowing that we have a sense of power in managing our health and fortunately, “patient empowerment” is an increasing trend when it comes to management of diseases. It was not long ago that it was felt that the medical community alone could provide necessary solutions for our health and diseases. For example, it has only been within the last several years that home blood pressure monitoring has become commonplace, and there is probably not a medical professional alive that would discourage this practice. In fact, in many cases a wise doctor today will even request ambulatory BP monitoring throughout the day (with an accurate device) before commencing pharmaceutical hypertension treatment. It is recognized that blood pressure varies considerably based on diurnal patterns, medication side effects, and mental states - especially so called “white coat hypertension.” 

 

As a result of these innovations and widespread acceptance of home monitoring of blood pressure, there have been advances in treatment that extend beyond the standard pharmaceutical interventions. For example, because of technology and recent discoveries in the effects of breathing patterns and stress on blood pressure, devices like Resperate (in conjunction with computerized BP feedback) have allowed many to reduce or eliminate blood pressure medications. Also, the valuable feedback which has come from home monitoring of blood pressure has allowed doctors to make better diagnoses and determinations of appropriate medications and dosages.

 

Similar to hypertension, the home monitoring of parameters associated with blood sugar and insulin have become commonplace, and before such practice, the successful management of diabetes was extremely difficult. With the advent of home glucose monitoring, patients are now able to accurately judge the glycemic load needed to maintain a healthy glucose range and adjust both their diet and medications or insulin to the optimal levels. Such feedback of “real life” diet and lifestyle influences is invaluable to both the patient and their doctors.

 

However, in the area of home eye pressure monitoring for those with glaucoma (or at risk), there seems to be a belief that pressures are somewhat static. But as evidenced by those with much experience in home tonometry, nothing could be further from the truth.  Because there are few current interventions besides eye pressure control in the treatment of glaucoma, and because higher than normal eye pressures are the main known risk factor, there is much to be gained in patient empowerment by being able to gain a thorough understanding of one's eye pressure patterns.

 

 

Several years ago, Dave, who is the founder of the original Fiteyes blog and website, was diagnosed with glaucoma. Not being satisfied with the limited treatments which were available through conventional medicine, he embarked on a journey to become more personally involved in managing his disease of glaucoma, and to search for alternate means to empower himself to prevent further optic nerve damage and heal himself. Because eye pressure is the number one identifiable parameter and risk factor for glaucoma, Dave began to explore means to measure his own eye pressure, and this led to the experimentation with a number of tonometers suitable for self measurement of intraocular pressure. It also led to the discovery of life variables which affected his pressures (mental states being the number one identifiable factor).  Therefore, much of what has been learned about self tonometry and shared in these articles, is largely attributable to Dave and other pioneers who have begun the same journey. You can learn about Dave's adventures of discovery by reading His Blog. 

 

 

As has been pointed out, tonometers for home use is still an evolving area with device makers in various stages of their regulatory approval process. You can learn more about this by reading a companion article, Choosing a Tonometer. However, this has not prevented dozens of self 'tonometrists' from reaping the benefits and peace of mind from monitoring their own eye pressures for many years now. At Fiteyes, we are confident that with more glaucoma studies revealing the need for frequent and 24 hour sampling of eye pressures, the medical community will finally catch up to what Fiteyes tonometrists have known all along! 

 

 

At Fiteyes, we are way ahead of the curve in bringing credibility to home tonometry amongst glaucoma and glaucoma suspect patients. With the help and support of doctors like renowned glaucoma specialist Robert Ritch, and gaining publication exposure such as Self Tonometry in The Management of Glaucoma, the practice of self tonometry can only expand. 

 

In summary, the practice of self tonometry is the self monitoring of eye pressures throughout the day (and night when possible) using either an air puff tonometer like the Reichert, or a portable tonometer like the ICare. We at Fiteyes record our eye data output from the tonometer for the purpose of analysis and reporting based on many user chosen variables. Some of our tonometrists do only routine checks for adjustment of eye medications and to provide useful feedback to their doctor. However, many of us are getting very involved with a more scientific approach and even move beyond simple management and data gathering and delve into the areas of mental state effects on eye pressures, posture and sleep positions, exercise, meditation, effects of various foods and substances, detailed charting of diurnal pressure curves, and other avenues of discovery which we believe will lead to empowerment over our disease and improvement of our life in general!