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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.  
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.
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