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Your doctor's intraocular pressure measurements are "very sketchy evidence"

Submitted by dave on Sun, 05/13/2012 - 11:54am

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/

Glaucoma medication allergies, Serene Impulse and emotions

Submitted by dave on Sat, 05/21/2011 - 4:28pm

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:

glaucoma eye drop medication allergy

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

Glaucoma, elevated intraocular pressure, membrane permeability and emotions

Submitted by dave on Sat, 05/21/2011 - 4:07pm

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.

Who can we trust to provide good advice about natural glaucoma treatments?

Submitted by dave on Sat, 01/15/2011 - 2:08pm

The title of an article by Dr. Mercola caught my attention. He wrote an article on his website and entitled it, "Six Sure-Fire Tips to Prevent Glaucoma Naturally".

Let's examine Dr. Mercola's suggestions one by one and see if they are sound.

Some of my favorite articles on FitEyes.com

Submitted by dave on Tue, 12/07/2010 - 3:03pm

FitEyes favorite articlesI 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.

Example Letter to Doctor Requesting a Prescription for A Tonometer for Home Monitoring

Submitted by dave on Sat, 11/20/2010 - 11:30am

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 ______,

Recommended Doctors - Posting Rules

Submitted by dave on Sat, 08/28/2010 - 11:12am

In this forum you may post information about doctors you know to be supportive of home eye pressure monitoring. In my experience, most ophthalmologists and doctors of optometry will offer support to motivated patients who wish to monitor their eye pressure at home. However, some doctors are enthusiastic while others are reluctant. If your current doctor is reluctant to support your desire to do home monitoring, you can help educate your doctor.

Many FitEyes members have won over their doctors by simply discussing the topic with them. Sometimes it takes more than one discussion.

How to Buy a Tonometer and Join FitEyes.com

Submitted by dave on Fri, 05/07/2010 - 10:59pm

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.

Filed Under (tags):

Are handheld or portable tonometers appropriate for home eye pressure monitoring?

Submitted by dave on Thu, 04/22/2010 - 12:29pm

In any tonometer (based on today's technology), you can have some, but not all of, the following:

  • ease of use
  • accuracy (reliability and validity of data)
  • low cost
  • portability

handheld portable tonometerPeople 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.

Leading Medical Specialists From Around the World Coalesce Around Self-Tonometry

Submitted by dave on Sun, 01/31/2010 - 11:43am

Leading Medical Specialists Support Self-Monitoring of Eye Pressure by Glaucoma Patients;

Self-tonometry has Potential to Transform Glaucoma Treatment, Says Co-Author of Recent Journal Article

self-tonometry eye pressure monitoringGrowing 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.

How to login to FitEyes.com

Submitted by dave on Thu, 05/14/2009 - 2:44pm

Welcome. Your FitEyes.com login name is your username (not your email address). If you have forgotten your username, youcan use your email address instead to log in. If you have forgotten your password, see item "C" below.

Please log in using one of these three options:

A. You Have Never Registered Before:

Scientists Discover New Role for Vitamin C in the Eye and the Brain

Submitted by dave on Tue, 07/26/2011 - 12:57pm

Optic nerve cells require vitamin C in order to function properly. Henrique von Gersdorff, Ph.D., a senior scientist at OHSU's Vollum Institute and a co-author of a new study showing how essential vitamin C is in retinal nerve cells had this to say:

We found that cells in the retina need to be 'bathed' in relatively high doses of vitamin C, inside and out, to function properly.

Can any natural system of medicine -- homeopathy or naturopathy or other -- cure glaucoma?

Submitted by dave on Fri, 05/27/2011 - 6:13pm

When thinking about the fundamental principles of health, I have to wonder how effective any pill (homeopathic or vitamin or other) can be for a chronic disease like glaucoma that takes decades to develop.

In another thread on glaucoma, emotions, stress and NTG, Dr. Ritch said:

Pigmentary dispersion syndrome is associated with perfectionistic, detail-oriented, high stress people.

No herb or vitamin pill is going to change those traits. (Even psychiatric medicines won't fundamentally change them -- only suppress them, at best.) The research from psychoneuroimmunology (see Dr. Candace Pert's work) shows that these personality traits turn into biochemical molecules in the body -- powerful chemicals that are more potent and more abundant than most pharmaceutical medicines --- and that come in a endless supply day after day. We wake up every morning and never forget to put on our personality. When we do so, our body is flooded with the biochemical signature of that personality. Any pill we take does little more than put a small dent in that massive stream of internally manufactured biochemical compounds. 

Think about that while reading this quote from a book by respected neurosurgeon Norman Shealy, M.D.**

Perhaps the best work in this field has been done by Dr. Caroline Thomas of Johns Hopkins Medical School. Her prospective studies of medical students have shown a high correlation with personality. Relatively specific personality quirks or defects predispose one to high blood pressure, tuberculosis, heart attack, cancer or suicide. These traits are present twenty to thirty or more years before the onset of disease. It appears that our “life script,” meaning our unconscious decisions regarding how our life will play itself out, provides a long-term attitudinal precursor of illness.

I wasn't familiar with that research in any detail, and I'm not relying upon it -- but this is essentially the same conclusion my own personal research on intraocular pressure led me to, and it is a core message of FitEyes because it conforms to time-tested principles of more than one traditional system of healing.

Here's the succinct way I like to state it (based on Ayurveda):

Consciousness structures the physiology.

Our habitual thought patterns, emotional patterns and lifestyle habits shape the form and function of the material structure of the body over time. We become physically who we are emotionally and psychologically. This is the most fundamental and powerful force shaping the development of any condition in the human body. Given that fact, how can we expect some little pill that we take to radically alter these long term trends?

Prudence, Horror and Intraocular Pressure

Submitted by dave on Wed, 03/30/2011 - 5:21pm

Recently we had a discussion on the FitEyes email list about experimenting with glaucoma medications. As part of that discussion, people expressed that they were horrified or fearful. At least one person responded by advocating a prudent stance. I certainly do not disagree with the advice given. In fact, I think everyone who responded to the original post was in agreement that the thing the original questioner contemplated was totally inappropriate for the person's skill level. So that was the end of that discussion, rightly so.

Filed Under (tags):

Turn yourself into wine

Submitted by dave on Wed, 03/30/2011 - 3:45pm

This captures a lot of what glaucoma means to me. Iti captures my experience of the initial bitterness of glaucoma eventually becoming sweet. Glaucoma positively changed me to my core. Glaucoma has enriched my life beyond anything I could ever have imagined. By the way, Joanna Macy is worth reading.

I am loathe to take glaucoma eye drops because of the potential side effects

Submitted by dave on Thu, 02/03/2011 - 10:52am

 A new FitEyes.com member wrote:

Hello, I have a query I would like some advice on.  I have only just joined and this is all a new area for me so please forgive me if i'm covering old ground.  I was diagnosed with early stage Glaucoma in one eye this week.  I have been given Xalatan drops to take.  I am loathe to take these because of the side effects.
 
Do I need to take these?  Are there other alternatives and methods?  Any advice would be much appreciated.
 
Thank you
 
Hi and welcome to FitEyes.
 

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