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This week the FitEyes community provided important answers to my emotional question about checking my eye pressure at home. I asked,
Leading Medical Specialists Support Self-Monitoring of Eye Pressure by Glaucoma Patients; Home Monitoring has Potential to Transform Glaucoma Treatment, Says Co-Author of Recent Journal Article 
Growing recognition among leading ophthalmologists and glaucoma specialists of an alternative option for measuring pressure in the eye may offer new hope for four million Americans – and millions more people worldwide – who risk permanent blindness, says a co-author of a recent article in the Survey of Ophthalmology.
Who are the expert glaucoma MDs that are in full support of self monitoring?
Are there glaucoma research papers or clinical trials that support direct benefits of self tonometry?
Occasional IOP testing by MDs is not a highly profitable procedure, so why not transfer some of the data collection to the patient?
A FitEyes member has recommended Brian A. Francis, MD, MS after trying six other glaucoma specialists who were not to her liking. The FitEyes member has just purchased her own tonometer and will be using it with the full support of Dr. Francis.
Title: Associate Professor of Clinical Ophthalmology
Department: Department of Ophthalmology
Locations: Doheny Eye Institute
Areas of Treatment:
A FitEyes.com member asked the following question:
On the FitEyes email list we had an interesting discussion. I would like to share my response.
Here are my thoughts on this topic of altering IOP without medications:
Dave,
Am I correct in concluding that the tonometer somehow offers objective evidence of thoughts and emotions, and that this feedback leads to a process of self-discovery and a realignment, or better adjustment, of the self to the external world? As you know I do not have a tonometer yet, so some of what you have to say about the process I cannot understand at this point, but I would like to gather the general idea. I will be out of town the rest of this week, but definitely will want to revisit this exchange so that I can come to understand.
Mike
Log in to your account at insight.fiteyes.com and you will notice a new feature that lets you edit the notes for your eye pressure readings right on the webpage! Check it out.
More new features are on the way.
surely its perfectly normal for eye pressure to go up under certain circumstances. Just like our bp goes up and down. anne
We now know that intraocular pressure does respond to events in our lives, to our state of mind and emotions and to stress. However, before FitEyes came along in 2006 (and for several years afterwards) these facts were not recognized.
See this FitEyes article from Feb 2007:
http://fiteyes.com/Does-Stress-Increase-Eye-Pressure-For-Everyone
The standard medical opinion is that stress does not affect eye pressure (intraocular pressure). For example, see "Glaucoma - Frequently Asked Questions" at The Eye Institute states:
"As far as we know, stress does not affect eye pressure or the health of the optic nerve."
Another example of the prevailing medical opinion can be found in a Wills Glaucoma chat transcript on Stress and Glaucoma from July 20, 2005:
Patient: Does being nervous or stressed increase the IOP (intraocular pressure) as it does blood pressure?
Dr. Elliot Werner: Not as far as we know.
Even today many ophthalmologists will deny that stress affects intraocular pressure. They will further deny that non-stressful events such as Bailey described could affect eye pressure.
In any tonometer (based on today's technology), you can have some, but not all of, the following:
People tend to give a priority to portability and low cost. New products aimed at this feature set have recently been announced. Does it make sense to utilize those devices for self-tonometry?
We have to agree that any trade off that doesn't include reliability and validity of IOP data invalidates the whole endeavor of self-tonometry. Not only is it meaningless to do it if the data is not of sufficient quality upon which to make important decisions, but it could actually be detrimental to do self-tonometry in that case.
With today's technologies, portability entails user-alignment (in the context of self-tonometry). Proper user-alignment to produce a valid measurement, by definition, depends upon user skill as well as various specific conditions of each measurement. User-alignment, regardless of the tonometer, is difficult! (User-alignment is defined as the operator of the tonometer having to align the tonometer with the eye manually. Alignment is a very precise process requiring a steady hand, good eyesight, training and practice.)
Therefore, the requirement of user-alignment conflicts with the requirement of reliability and validity of IOP data. We cannot guarantee reliability and validity of IOP data when variable user skills are required to produce that data.
If any decent ophthalmologist or scientist (or intelligent thinker) considers a set of IOP data, they must consider how the data was obtained. If patient skill played a critical role in producing that data, as it does when user-alignment is required, the clear thinking person will immediately discount that data. Therefore, the self-tonometrist's efforts may not produce much of value.
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