My Expectations

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.

It turns out the overall averages for today are almost identical to yesterday's.

Left 13.3; Right 16.9 (differential 3.6)

We collected 117 IOP measurements today, which is about normal. In many ways, today was a typical day. However, it didn't meet my expectations -- and in that respect, it is again a typical day!

I almost never achieve everything I hope to on a typical day and that is probably the most common trait among most days for me. I have never thought about it in exactly those terms, but as I write this, I am reminded of the pressure I often feel to accomplish more.

"I’ve always got such high expectations for myself. I’m aware of them, but I can’t relax them."
-- Mary Decker Slaney

This quote from U.S. runner Mary Decker Slaney (who was ranked 4th in the world at just 15 years of age, and who ran competitively for almost 2 decades) is something I can relate to. I certainly can relax. But I'm realizing that relaxing is different from relaxing the expectation I have for myself.

I believe my high expectations for myself, my inability to relax those expectations much, and my habit of putting pressure on myself relate to my IOP on a subtle level.

The emotional state of constantly feeling pressure is translated, over a lifetime, into pressure in the physiology.

It will manifest in different ways, depending on an individual's genetics and lifestyle. That idea may sounds like nonsense to those of us trained to think in Western ways, but my statement would be completely obvious to someone familiar with traditional medical systems from Asia (such as Ayurveda). Those traditional system have introduced plenty of new knowledge into modern medicine and modern science, so I believe it is rational to consider the possibility that "constantly feeling pressure" is related to my IOP over the course of my lifetime.

I also think my IOP data indicates that my short term feelings of pressure (or stress and anxiety) have an impact on my IOP hour by hour, and even minute by minute. Today's data seems to support that statement, and any previous day posted here on my blog probably supports it as well. However, what doesn't seem so clear to me is why today's average IOP in my right eye is nearly 17. I would have expected something closer to 15, so I'm a little confused. It is also unsettling that my right IOP was often 5 points higher than my left IOP today. (FYI, the Goldman tonometers usually don't pick up this difference very well. The non-contact tonometers usually do a better job identifying periods when my right IOP is higher than my left. In the future, I'll have to write a post about my experiences with the accuracy of different tonometers.)

I can't offer any explanation for the higher IOP in my right eye today. I think the next few days will shed more light on the meaning of today's values. However, I'm flying out of town for a conference on Friday (the day after tomorrow), and that will have an effect on my IOP as well as my ability to record measurements.

I'm sure I'm not seeing the story my IOP measurements are telling today. I wanted the numbers to turn out a certain way and they didn't. I find myself focusing on why my IOP in my right eye was often 5 points higher than my left eye throughout the day. However, another story that may deserve more of my attention is the story of what happens to my IOP when I lay down to go to sleep. Notice my IOP values at just after midnight. My right IOP jumped up quite a bit. I often (but not always) see this trend if I check my IOP during the night or first thing in the morning. I might need to use more Timoptic for better control at night, even if my daytime IOP values are acceptable. I'm going to have this discussion with my ophthalmologist.

The last comment I'll make is that past data have indicated that working on the computer when I'm doing focused, but non-stressful work (working on a spreadsheet would be an example) is correlated with low IOP in both eyes. Obviously, when I do stressful work on the computer, my IOP is higher. We've seen that hundreds, if not thousands, of times in the data. (As of today we have 8215 IOP measurements recorded.) However, today is unusual in that work that didn't feel stressful did correspond with higher IOP values - see 8:07 PM in the table below. Maybe the work was more challenging in some way than I realized. I didn't feel stress, but the high IOP value indicates that something wasn't ideal.

Here are today's IOP values:

Time	Left	Right	Comments
9:48	14.3	20.7	Working at computer.
11:26	21.0	20.7	Working at computer. Feeling anxiety.
14:09	16.0	21.7	Before brushing teeth.
14:20	13.3	16.3	After brushing teeth. Not trying to relax (or feeling any more relaxed).
14:40	11.3	16.3	After 5m frisbee with my dog, 5m long swing, 3m frisbee.
14:42	11.3	16.3	Repeated measurements.
15:02	10.7	12.3	After 7m weight lifting (arms).
15:03	10.7	12.7	Repeated measurements. No changes.
15:05		12.0	Repeated measurements. No changes.
16:07	11.7	13.3	After eating and reading a news magazine.
17:54	13.7	18.3	Working at computer followed by a short break.
20:07	14.7	22.0	Working at computer. Challenging work, but not feeling any stress.
20:18	11.3	16.0	After 6m weight lifting (back).
20:19		16.0	Repeated measurements.
20:20		16.0	Repeated measurements.
20:46	11.3	16.7	After shower.
22:21	12.7	16.3	Working at computer. Challenging but relaxing work.
23:16	13.7	16.3	Planning travel/conference attendance.
23:29	13.3	13.3	Getting ready for bed.
0:04	14.3	21.7	After laying down.
1:37	13.3	19.7	Working at computer. Interesting work. Not stressful, but challenging.