Jacqueline wrote 5-1-2019:
I got my Reichart 7CR six weeks ago and have kept daily charts of frequent IOPs. This is an illuminating process. My observations so far:
History: I was diagnosed 20 years ago when I was 48. I had a patch of visual field loss that my Costco optician picked up. I saw a GS for awhile but left because he showed no desire to educate me and I decided I preferred knowledge over patrimony. I’ve been seeing my current eye doctor ten years, a few times a year to monitor pressures. I drop in for weekly IOPs with the staff, and a thorough annual exam. I average mid-20s and have gone as high as a sporadic 30, which freaks me out because I haven’t had any explanations as to why. Once after exercise I was 19/21 but that was an anomaly. Nearsighted since age 12; have had about 25 vision therapy sessions and have lowered my prescription from 5.0/5.25 down to 3.75/4.0 in the past two years.
I take brimonidine 3x day. I eat an exemplary diet (I own an organic farm and am a writer), spend a few hours a day online, do farm exercise (lifting, digging, weeding) but not much aerobics. I have an IRIS blue filter on my computers. My bed is slanted and I sleep on my back. I take 15 supplements a day, have a spiritual practice that brings me peace, and have a rewarding marriage and good friends.
Other relevant history of traumatic events: Near-drowning age 7. Molested by a neighbor age 12. Age 30 severe dehydration after an accident at sea with temporary blindness that likely is the cause of a small area of blindness. I mention these because I believe our response to trauma can be a contributing factor in developing glaucoma.
Until I got the Reichart I assumed my IOPs were fairly steady. My first IOP that day at 4pm was 31/27. After the tech left, I sat down and meditated for 30 min and went down to 28/27. An hour later I was 25/22. I was elated.
Till that day, every time I thought about my IOPs, I worried. Now, in my own home, I could learn the language of IOP, training myself like on a biofeedback machine. I measured hourly and by 7pm I was 17/16. Truly, I felt empowered.
What I have learned so far:
1. After tracking for a month, my graphs showed that I have a natural daily cycle. Midday I am usually in mid 20s, then in late afternoon, I slide down into the teens. By the time I go to bed, I’m usually 14-15 and have been as low as 11-12. I am steady through the night and, using a contoured pillow, I can sleep on my side with no increase. (Hooray! I can spoon with my husband again!) I wake up in low teens.
I don’t like to drive in rush hour so ALL my appts have been midday. The IOPs have always been taken at the highest point, so my doctor and I both thought the mid to upper 20s were my average IOP. My doctor was shocked to see the consistency and it was he who pointed out that all my IOPs with him were in my peak window.
Also we had been experimenting with light therapy of brief (3 min) stimulation followed by calming lenses. After seeing my graphs, he realized I do not need any further stimulation during midday at all and we ought to switch to calming my nervous system instead.
2. Stress causes increase. Even a brief and petty exchange of words with my husband will raise it 5 points. One day I was gardening and thinking of the state of the world and over 3 hrs, raised it 8 points. Stressful thoughts trump the bliss of gardening every time.
Interestingly, positive stress also raises IOP for me. Two hour meeting with girl friends or a long phone call will do it, too. On retrospect of those times, I credit that to how animated I am in conversation. I may work on less animation and more serene presence.
I had workmen in the house for a few days and I found the chaos difficult with high IOPs while they were there. After a few days, I chose not to let that be an upset and I went back into low numbers. Hmm...
3. Lowest IOPs are after meditation, prayers of forgiveness and goodwill to others,
4. Exercise, a hike or even a half mile walk, causes a rise in the hour after, followed by a steep reduction the rest of the day -- as much as ten points.
5. Going outdoors is good. Gardening is good.
6. Divergence exercises (vision therapy sessions) consistently lower IOP 5-6 pts. Occasionally I boost up 2 pts immediately after, then down. I believe learning this skill is more significant than we realize. Hard focus = eye strain = rising IOPs.
7. Fun is good. Doing anything I call fun (choosing new tiles for bathroom, seed catalog, funny movie) can cause a ten point drop over a few hours.
8. I am religiously consistent with 3x day brimonidine.
9. Crap in air (smoke, dust, sawdust) elevates IOP.
Things that don’t seem to have much affect:
1. Food. I already eat super healthy and had stress around dining out (could there be canola oil in this? Did they add sugar?) I was crazy-strict and never ate outside my parameters. Surpise: As an experiment, I ate a dessert at a nice farm-to-table restaurant and it had zero affect. Once a week I have allowed myself to stray and I’m fine.
2. Contrary to my prior fearful belief, computer time doesn’t seem to make a difference unless it is something stressful, like 2 hrs with tech support, but I believe that should really be in the stress category. Long tech support calls = add 8 points. I have a blue light blocker that I believe helps.
3. My self-perception of when my eyes felt pressured was completely off. As a biofeedback machine, the Reichart is far better at measuring. I am working on recalibrating ocular proprioception but I am not there yet.
Funniest moment: I had to go to the bathroom but was busy and I waited till I really had to go. I checked IOP and it was 23/21. Used bathroom, came in and measured one minute later and was 18/17. Tried it again to confirm. Ladies, when you have to go, go now. Second funniest: Asking my husband to have sex so I could measure IOPs before and after. He applauded my sudden interest in science.
So what causes my midday peak? I wondered if my morning vitamins might do that so I went off them for a few days but numbers are the same. So far all I can think of is that this is the time I engage with the world, and perhaps I need to change the way I do that.
My eye doctor and vision therapist suggested that my next experiment is to go outside in the sun every time my pressures rise. Easy full-spectrum light therapy. I’ll graph that and report back.
My overall impression after six weeks: High IOPs are -- in my case anyway -- more related to how I respond to stress. What if glaucoma is the result of chronic emotional imbalance? Is this why there is no cure? Are each of us internally responsible for monitoring and modifying everything from anguish to ennui to prickliness to peace and joy, with the result being that we learn to live in a constancy of generosity?
Jacqueline wrote 6-22-2019:
My experience is that glaucoma, for me, is stress-based. Since I got a Reichart 7CR back in February I have been able to track my IOPs many times a day. An average day had me in the mid-20s during the day with an occasional dip down to the high teens later in the day and evenings.
I worried about nutrition a lot, despite the fact that I own an organic / biodynamic farm and eat incredibly healthy. I added many supplements, worried every day about my situation, slept in a tilted bed, got blue blocking screen on my computers, and then I worried more.
Since getting the 7CR, I am able to make immediate and longer term assessments about what affects IOP. Given the high quality of my diet, I see that food was not an issue. I eat organic, farm-raised, nothing refined. I eat meat maybe twice a week (ours), eggs, whole grains, raw dairy and a lush amount of veggies and fruits daily, raw nuts, honey, olive oil and coconut oil. That’s my diet in a nutshell.
But stress surely was a biggie. I have realized that charting stress was not simple at first. It takes a lot of self-perception to catch myself in stressful thoughts, which I chart-note aside the IOP for that hour. In the past five months I have learned a lot about myself.
When I am stressing about a real-or-imagined thing, I have an internal heckler that has a good deal to say about every thought. If I choose to continue on with that worrisome thought, my IOPs will rise. When I have the presence of mind to opt out of that one-sided conversation, my IOP readings drop. When working in the garden, I can listen to reworking of an argument I had five years ago or I can choose to see the beauty of the flowers around me. Between February and April I made steady progress.
I was about to check-in in early May because I had gotten my IOPs down to a more healthy place, but that same week we got rear-ended while stopped in traffic and I pulled some muscles where the seat belt yanked. My IOPs were strangely calm the rest of that day but the very next day they went right back up to my February normals, mid-20s day and high teens at night with a few spikes even higher.
For the next month I had Feldenkrais sessions with my physical therapist and cranio-sacral sessions with my osteopath. The first few weeks they made some difference but I was physically hurting still so I couldn’t maintain the results. By the fourth week I saw 8-10 pt drops in IOP during the afternoon following the sessions, from 25 down to 15-16. And I got a lot better.
The past few weeks I have stabilized more. Average now is mid-teens when I wake up. If I have a meeting or am rushed, I may hit the low 20s briefly, but I can immediately (no kidding!) decrease my IOP 3-4 points in 15 minutes by doing calm and slow deep breathing, clearing my mind of extraneous thoughts, letting go of any imaginable transgression (forgiveness is very powerful), and relaxing my body. Within the hour I am able to get back into mid-teens and even lower.
Last week I discussed my IOP charts with my doctor and we agreed that I could decrease the brimonidine that I had been taking 3x day for the past few years. My new schedule is to take them when I wake up. I don’t take the afternoon drops if my readings are mid-teens which is becoming my new normal. I rarely take them in the evening because IOPs are usually 12-15 and have been as low as 10. After all that time in the mid-20s months ago, I now have entire days in mid-teens.
Access to my IOPs has been a game-changer for me. I have been able to develop a communication with my own body and psyche that are very useful.
My annual OCT, VET, ERG is in July and I’ll share what I learn.