Blogs

From "Review of Ophthalmology":

most human IOP measurements are “snapshot” measurements—a single reading taken periodically in a doctor’s office. Any conclusions about the nature and impact of fluctuation have therefore been largely based on very sketchy evidence.

That statement, from a 2011 article by the Senior Editor of  "Review of Ophthalmology," captures the motivation that lead to the creation of FitEyes six years ago and that has continued to motivate our engagement with high frequency home eye pressure monitoring (where we recommend multiple measurements per day).

The article can be found here: http://www.revophth.com/content/c/28662/

Trabecular Meshwork Cell (detail)

This is the winning image for North America -- IN Cell Image Competition. It shows the internal structure of a single trabecular meshwork cell.

This is from an email conversation between me and an ophthalmologist on the topic of research data.

In a recent discussion on the FitEyes email discussion list we had an interesting exchange about allergies to the glaucoma eye drops. If you want to see how serious this can be, one picture is worth a lot of words:

On Fri, May 20, 2011 at 7:39 PM, a FitEyes member wrote to the discussion list:

For those of us with glaucoma or ocular hypertension, our goal is for the fluid in the eye (aqeous humor) to be able to flow freely out the two exit pathways from the eye. In this context, we had a recent discussion on the benefits of fish oil and DHA for glaucoma. In this discussion, someone raised this point:

Quote: "fish oil can improve membrane permeability"

That's a useful fact on its own. But that got me thinking about what I have learned from teaching and practicing Serene Impulse (and doing so as both a glaucoma patient and a personal self-tonometry researcher).

Fish oils (including DHA) may have a small effect on IOP -- but much less of an effect than other things I have identifed as a result of mixing self-tonometry and Serene Impulse -- and also as a result of interacting with other tonometer owners in the FitEyes community.

In pursuing knowledge that will help me manage glaucoma, I have a guiding principle: don't waste your time going after the small change. Go for the stuff with the big payoff. Mental and emotional tension, which always lead to tissue contraction, are a key area where we can find that big payoff. For some background, please see this link:

http://fiteyes.com/blog/dave/the-two-most-important-facts-you-should-know-about-glaucoma

And here's another related post by Bailey:

http://fiteyes.com/blog/bstruss/mental-emotional-and-lifestyle-factors-are-the-powerful-iop-influencers

And I will expand on all of this in the present article and tie it together into an (informal) theory of elevated intraocular pressure.

If I can secure a prescription from my doctor I would like to join with other self-tonometry participants.

I think I understand the information that participants are responsible to gather and submit.

What are the steps I need to take to become involved?  Assuming I can get a prescription.

Thank you,

Judy

Here is a video presentation by Doctor Ritch explaining how to properly place glaucoma drops into one's eyes. This is particularly helpful for patients with low vision. Also, the technique of punctal occlusion is addressed, and this helps to deliver the maximum amount of medication to the eyes while meanwhile reducing systemic absorption.

I think the following list represents some of the most informative and useful articles on FitEyes.com. There are thousands of articles on FitEyes.com, so many good ones will not be on this list. But this list is a good place to start reading if you are new to FitEyes.com. If you are not new to our site, please make sure you have seen these articles.

Please feel welcome to add comments to this post to mention your own favorite articles on FitEyes.com.

This is an actual letter drafted by a FitEyes member for the purpose of obtaining a prescription for a tonometer she could use to monitor her eye pressure at home. She had previously not had success obtaining a prescription, but with this letter her doctor agreed! I asked her permission to share her letter. (I removed personal info before posting it.) Here it is.

Dear Doctor ______,

After obtaining the Reichert 7CR and understand my eyes response to different situations, times of day and other stimuli, this first set of result is very encouraging for me after this small changes I have made.

Since I am the type of person using the left-brain, as is described in this post, as part of several tests performed simultaneously I eliminate caffeine from my diet in all its forms.

http://fiteyes.com/mistake-of-the-intellect

I am learning so much more about these patterns and their effect on my IOP all the time. Recently, I had a major emotional crises with my family concerning a simple misunderstanding and lack of communication. Interestingly, my eye pressures did not rise in the first couple of days (though the stress was off the charts). However, after a couple of days, my eye pressures went crazy, and even with lumigan, I could hardly get them below 20s.

I have had my tonometer for almost 6 months.  It has answered a multitude of questions about how my daily routine affects my health.  I didn't know, for example, that just taking a walk outside for a half hour or so would reduce my eye pressure, sometimes by as much as 50%.  I also didn't know that I wasn't one of the people whose pressures are higher at night--in fact my lowest pressures are at night.  (That was good news.  I was tired of sleeping with my head elevated).  

I have found no supplements that had any effect on lowering my IOP, but I have found that some supplements will raise my IOP quite significantly.  I know that out of control thoughts and periods of stress significantly raise my IOP in spite of the two drops I am using or any other healthy lifestyle choices I am making. 

Read more...

UPDATE: You have to purchase a tonometer directly through your doctor. As of mid-2011, tonometers are not aprpoved for home use in the USA yet. That is coming. However, you can still get a tonometer now. Doctors are allowed to prescribe medications and equipment for off-label use, so it is not a problem for your doctor that tonometers are not approved for home use. However, manufacturers and distributors of medical devices cannot recommend or sell a device for off-label use.

I have been part of FitEyes since 2006 and I bought my tonometer in late 2006. I've been using it almost every day since then. I am very calm about measuring my IOP perhaps 2 or 4 times a day (or sometimes not at all if away from home).

While away from home I use drops 'just in case'; at home I might go for several days with no drops while I monitor my IOP with my tonometer .

First of all, from the bottom of my heart, I have to thank Dave for leading me to my purchase of my tonometer; what a fantastic instrument!

Several years ago, my ophthalmologist said that I probably had what is called "normal pressure" glaucoma; my pressure was usually 15-16 whenever he checked me, and the highest he ever recorded was 19 on my right eye. He told me to find a glaucoma specialist, so I did.

I went to the specialist for a couple of years, but several things discouraged me from continuing to see him. I found another ophthalmologist; she was somewhat younger and, I thought, perhaps less apt to be running a Speede Oil Change type of service, to see how many people she could get through her clinic in a day. She was a bit better at the latter, but she refused to give me a prescription for a tonometer. I left her and quickly acquired a tonometer prescription; and by the way, the requirement for a prescription for a non-contact tonometer is as silly as the need for me to have a real estate broker's license to sell real estate, or for a city to have building inspectors.

by Robert Ritch, MD

Glaucoma is a progressive optic neuropathy characterized by a specific pattern of optic nerve head and visual field damage. Damage to the visual system in glaucoma is due to the death of the retinal ganglion cells, the axons of which comprise the optic nerve and carry the visual impulses from the eye to the brain. Glaucoma represents a final common pathway resulting from a number of different conditions that can affect the eye, many of which are associated with elevated intraocular pressure (IOP). It is important to realize that elevated IOP is not synonymous with glaucoma, but rather is the most important risk factor we know of for the development and/or progression of glaucomatous damage.