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Latest doctor visit confirms (to me) stress/IOP link!

Submitted by bstruss on Fri, 04/16/2010 - 5:23pm

I mentioned previously that my new glaucoma specialist had me on a drug wash out period to get off all glaucoma meds so as to establish a baseline (what a nerve racking experience!). During this several week wash out time, I learned that my pressures could get almost as low as when on xalatan, but they also were much more volatile. Anyhow probably in anticipation of my doc visit, yesterday my pressures really start getting up there, as I had several readings crossing 30 and could not seem to get them down even with exercise. Therefore, I was VERY nervous for this morning's appt, as my first awake pressure was 37, and when I arrived there, she did other tests prior to the IOP reading - including a first time OCT RNFL analysis.

Anyhow, when she got around to checking my IOP, I was pretty scared not knowing what these other tests results were etc.  SOoo, the IOP readings were (not surprisingly) 30R, 27L at 8:45, and supine were 31.5R, 28L. Then I got the good news that my RNFL and other tests were normal, and that she figured because I have large CCTs (645R, 615L), that adjusted actual readings were probably several points lower (though I still think corneal dynamics test is needed). I also had great fear because that which first sent me to a doc years ago was the occurence of halos - and because my understanding is that this implicates pressures usually 50+. When I questioned her about this, she said that in her many years of practice, she has only run into a very few true halo cases resulting from glaucoma, and they were angle closure cases. Therefore, she thinks that my halos were manifestations of ocular migraines (what a coincidence huh?). So we are no longer talking iridotomy, glaucoma, etc, but just ocular hypertension.

Anyhow, there were other interesting details to my visit, but my point in relating this is that because I was told that I am in a very low risk group for glaucoma because of all of my test profiles, my stress after the visit deflated like a balloon and my pressures (without any drops still) ended up in the teens for the rest of the day.  Because I have extreme amplyopia in my right eye, she still wants to be conservative and experiment with a drop regimen, but I feel quite a bit lighter today. 

 PS: A recent OHT study for low very low risk group ocular hypertensives indicates a conversion rate to glaucoma of only 1% difference (8% vs 7%) of those medicated over several years and those not. I will post the link when I can find it again.

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