May I introduce myself to people who do not yet know me:
I am a man of 45, live in The Netherlands, I am self employed, married with one daughter of 15 still at home.
I am a patient of Prof. Dr. Hans Lemij of the Rotterdam Eye Hospital.
I have been diagnosed with Pigmentary Dispersion Syndrome and early stage glaucoma early 2006.
Mid March 2007 Dr. Lemij performed a Peripheral Iridotomy both eyes.
My IOP without medication was around 28 mmHg both sides as average. With prostaglandins my IOP is about 18 mmHg. These prostaglandins cause me major side effects, I get photophobic and severe irritation of the upper respiratory system. I have tried to use all three versions apart from Travatan Z which is not available in The Netherlands. Duotrav works very well in bringing the IOP down with a 2 day lasting effect but I do not tolerate the Beta blockers very well.
My own self tonometry data has shown that Alphagan was not capable to bring my IOP down, in fact during Alphagan use one day I reached my highest ever 38 mmHg average reading.
I have changed back to Xalatan end of August but my respiratory problem returned after two weeks. Now on a wash out period to try Travatan for a while and I might want to try Travatan Z.
The following is documented about BAK, which is the preservative used in Xalatan:
"Steinsvag: benzalkonium chloride has toxic effects on human respiratory mucosa and human neutrophils. It destroyed mucosa and inhibited human neutrophil action. Benzalkonium chloride induces mucosal swelling, which explains why the presence of this preservative in a decongestant spray aggravates rhinitis medicamentosa."
Dr. Lemij does not yet want to do laser trabeculoplasty as I am too young and he feels I will only have a short term benefit. Also I do not want to do any non reversible operation until all other resources are found not working.
Since June 2007 I own a Reichert AT555 tonometer, and I am participating in David’s self-tonometry research project. In fact, I will be working to grow the project and expand the research.
I learn a lot from using the tonometer in day to day situations.
Take just today as an example: since I stopped Xalatan 3 days ago my IOP has increased from 18~23 average to about 25~27. This afternoon did some similar measures after which I headed of to a birthday party by car. Had a most pleasant dinner and good time. Before I started Glaucoma medication I had no problem driving at night but after my first start with Travatan I do not like driving during dark any more (halo vision and eye ache).
But today I had to drive during dark and experienced again these halo's and eye ache so when I came home the first I did was measure my IOP. My left (non dominant eye) was 32 mmHg, then I relaxed, did some heart breathing, emptied my mind and measured a few times during 10 minutes. The pressure went down from 32 to 27 and down to 24. Reason in my opinion: my mind was worried during the drive, now did my night drive increase my IOP or the worries?