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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.

Continuous Positive Airway Pressure Therapy Is Associated with an Increase in Intraocular Pressure in Obstructive Sleep Apnea

Submitted by dave on Thu, 04/22/2010 - 9:41am

PURPOSE. Several reports have demonstrated an association between glaucoma and obstructive sleep apnea (OSA), though the origin of this association remains unknown. In the present study, the influence of OSA and continuous positive airway pressure (CPAP) therapy on intraocular pressure (IOP) and ocular perfusion pressure (OPP) was examined.

METHODS. IOP, blood pressure, and pulse rate were measured every 2 hours during 24-hour sessions in 21 patients with newly diagnosed OSA. A first series of measurements was performed before CPAP therapy, and a second series was performed 1 month after the initiation of CPAP therapy. OPP was then calculated.

My new tonometer is here finally!!!

Submitted by dave on Tue, 04/20/2010 - 11:11pm

best tonometer for home eye pressure monitoringA lot of new people are joining our group for home eye pressure monitoring (self-tonometry). Please allow me to welcome all the new users and share a few thoughts about what to do when your new tonometer arrives.

It is always best to leave the job of making judgments about your eye pressure -- in the context of your health care -- to your doctor. This is not just a disclaimer!

Part of the skill of managing your eye pressure effectively is to not think about it the way a doctor would. If you think there is a medical emergency, by all means call your doctor. But in general the best thing you can do is measure as often as possible and do everything you can to avoid playing doctor.

Do not diagnose your own intraocular pressure. Don't think about what it may mean in terms of glaucoma. This is a powerful skill, not a cop out. This is a powerful skill because we have strong evidence that one's state of mind affects one's eye pressure. You will begin to see evidence of this when you start monitoring your eye pressure.

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Eye pressure decrease with movement exercise like Qigong?

Submitted by bstruss on Tue, 04/20/2010 - 10:08pm

I wish to mention the technique Gyoshi Ho which  is used in Reiki. This techinque is also known as eyes healing and heres a small description about this technique : http://www.aetw.org/d_gyoshi.htm

Is possible that Gyoshi Ho can reduce IOP?

Dental XRays and eyes

Submitted by siestafiesta on Tue, 04/20/2010 - 3:09pm

Hi - just got back rom the dentist and could not help but notice they thought it was important to cover my lap with a lead blanket but my eyes - nothing and they are a whole lot closer to the Xray machine.  Given how much time I spend babying my eyes with good things to prevent oxidation - wondering if anyone has any comment on the impact of Xrays dental or otherwise.

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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.

Some glaucoma specialists are taking magnesium supplementation seriously

Submitted by dave on Thu, 04/15/2010 - 1:08pm

The effect of oral magnesium therapy on visual field and ocular blood flow in normotensive glaucoma

Note these conclusions! Also note that Josef FLAMMER, Professor and Head, Department of Ophthalmology, University Hospital Basel (Switzerland), recommends magnesium supplementation (so I am told).

Purpose. To evaluate the effect of oral magnesium therapy on ocular blood flow and visual field perimetry indices in patients with normotensive glaucoma (NTG).

EYE DROPS -- DANGERS LURK WITHIN By Bill Sardi

Submitted by Amanda on Thu, 04/15/2010 - 11:07am

Your eyes bother you. So you go down to the drug store and buy a bottle of artificial tears. There are so many brands you really don't know which one is best. Or you trust your eye doctor who may prescribe an eye drop for glaucoma or who recommends an over-the-counter eye drop for your dry, red, itchy, burning eyes. To keep the ingredients from spoiling, manufacturers add preservatives. It is these preservatives, even in doses as small as 1/10th of 1 percent, that are a cause for concern.

Continuous IOP monitoring devices discussed in Ocular Surgery News

rritch's picture
Submitted by rritch on Sun, 04/11/2010 - 10:30am

OCULAR SURGERY NEWS U.S. EDITION April 25, 2010

Three approaches for continuous IOP monitoring are being explored to find an ideal device that would accurately measure 24-hour IOP without IOP measurement noise, contact lens intolerance or other issues, Arthur J. Sit, SM, MD, said.

“We may just be getting to the point now with miniaturization, particularly driven by the computer industry, where we could potentially have clinically suitable devices,” Dr. Sit said at [a recent professional meeting].

Stephen Gislason's Alpha Nutrition Program

Submitted by jarek on Sun, 04/11/2010 - 6:23am

Stephen Gislason (MD) seems to me to link the ancient medicine with the contemporary one. He believes food can be healing. Especially when one is getting posioned by food wich is not good for him. In other words he believes that food (and other) allergies can be responsible for most of unexplained diseases. I have bought his ideas.

Narrow Angle Glaucoma: What should I do?

Submitted by kathyriley on Sat, 04/10/2010 - 4:27pm

I've been told by my internist that I need laser surgery for narrow angle glaucoma/plateau iris.  He indicated that there both conservative and more aggressive approaches. He explained that there is a more conservative procedure putting one hole in the iris, which has a 50% chance of success. If it is not successful, they you would have to go again and they would do a procedure putting in a lot of holes. That sounds very scarey. I would appreciate any feedback about these procedures. I would also appreciate any referrals to Glaucoma surgeons in the New York area who take insurance.

Preview of the Icare ONE handheld tonometer for home eye pressure monitoring

Submitted by dave on Fri, 04/09/2010 - 11:44am

My evaluation Icare ONE tonometer arrived today. I will compare it to:

    * Icare TA01i
    * Reichert 7CR Tonometer
    * Pascal Dynamic Contour Tonometer
    * Ocular Response Analyzer
    * Reichert AT555 Tonometer
    * maybe another one or two tonometers...

Look for a full review in the near future on FitEyes.com. UPDATE: I have decided not to publish my review of the Icare ONE at this time. Please read Are handheld or portable tonometers appropriate for home eye pressure monitoring?

Let me offer an analogy. If I were reviewing golf clubs, I would not include a review of a baseball bat. A baseball bat is not appropriate for playing golf. During the process of evaluating the Icare ONE, I came to a broader conclusion about all handheld tonometer and their appropriateness for self-tonometry (home eye pressure monitoring). Therefore, I feel it is better to have that general discussion first. You can read my thoughts here: Are handheld or portable tonometers appropriate for home eye pressure monitoring?

There is a related discussion on the Icare ONE here: New iCare ONE Tonometer Designed for Home Eye Pressure Monitoring

For now, here are some pictures of my evaluation Icare ONE tonometer.

Just arriving via FedEx (below). Some tonometers it will be evaluated against are shown in the background.

Icare ONE home eye pressure monitoring tonometer

 

Australian Bush Flower: Waratah Essence

Submitted by Sandro on Thu, 04/08/2010 - 8:24am

i've found this story about the waratah essence.. do you know something more?

Australian Bush Flower: Waratah Essence

The following Case Histories have been provided by independent practitioners.

Case History 1

Had a young woman as a client who had glaucoma. She took Waratah as two weeks on and two weeks off, and the glaucoma was reversed.

 

Cure for glaucoma which leads to blindness may be on its way: lymphatics found in eye

Submitted by dave on Wed, 04/07/2010 - 8:54am

Cure for glaucoma soon, says new research
newkerala.com/nkfullnews-1-125456.html

October 6th, 2009 SindhToday
Toronto, Oct 6 (IANS) Cure for glaucoma which leads to blindness may be on its way.

Canadian researchers have discovered an unidentified form of circulation in the human eye which may provide important clues to glaucoma.

The human eye is considered to lack lymphatics – a circulation responsible for pumping fluid and waste out of tissues.

But now researchers at the Universityof Toronto and the local St Michael’s Hospital say the inability to clear that fluid from the eye is linked to glaucoma which currently affects over 66 million people worldwide.

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