Does Stress Increase IOP?

Our discussions and planning for a new business venture have been getting progressively more intense during the last week. Today represents a peak in that "stress".

However, I want to attempt to better define what I mean by stress. I have reduced the stress in my life by a significant amount since I learned that I have glaucoma. In years past I put myself in situations of extreme stress and I wouldn't let up for long periods of time (months or years). For example, several years ago my partners and I had a $3 million investment that was not looking good. We felt me might lose all the money. I took responsibility for trying to turn the situation around and I worked extremely hard on it. However, I also got into some very heated arguments with people we felt were making bad business decisions. I had some serious confrontations at board meetings with company executives. I was also doing a lot of travel and working long hours (and usually not taking weekends off).

Today, by contrast, you'll see that I took some short breaks to play with my dog, and I wasn't involved in any serious confrontations and I didn't have to travel or do much else that was stressful. In fact, compared to past business deals, the current situation is a vacation.

In the past I was basically ignorant of the effects stress was having on me. I chose to ignore it (hoping that if I ignored it, it could not negatively affect me). Now I am trying to be very aware of (and sensitive to) any stress. The ability to frequently measure my IOP gives me a lot of feedback about how subtle thoughts and emotions affect me (and my IOP). For example, my overall average IOP for today is several points higher than what it was prior to beginning this new business venture.

Left 18.8; Right 19.3 (differential 0.5)

I started looking at average IOP values for the entire day a few weeks ago. I examined several weeks of past data. I found that daily average IOP values similar to "Left 16; Right 17" were not uncommon. By that measure, today's overall averages are several points higher.

I want to insert a comment about the differential here. My doctors are currently watching this value in order to adjust my medication. My normal medication routine the past two years has been to use one drop of Xalatan in each eye at bedtime. Currently, my doctors feel I may need another medication - and that it may be sufficient to use it in my right eye only. They have me experimenting with Timoptic GFS (XE) 0.5% in my right eye only. You'll notice that I don't use the Timoptic every day -- at least not yet. After we have more IOP data, my doctors will make a final decision about my medication. It is interesting for me to observe that the effect of the Timoptic lasts several days and it usually keeps the IOP in my right eye very close to the value in my left eye (the differential is close to zero). When the differential gets above 3 (that number is subject to change), one drop of Timoptic gel forming solution in my right will usually bring it back down closer to zero for a few days. Keep in mind that this is preliminary data and because my doctors didn't expect such a multi-day extended effect from the gel forming solution, this is a period of observation and data collection. I don't know what the final decision will be regarding my medication, but I think it is safe to assume that it will not be the same as the program my doctors are currently experimenting with.

Today my IOP is higher in both eyes. I suspect this is related to the stress of this new business venture in some way. Support for this assumption can be seen in the data below. Notice that my IOP is the highest after I finished the business meeting. I had about 45 minutes to "cool down" after this meeting before the IOP measurements were taken. I suspect my IOP would have been even higher during or immediately after the meeting.

Even leaving out the data point including the 24 value (the IOP exam after the business meeting), my daily averages would still be 18.3 and 18.9, which is above the trend of the recent past. It does seem like something has changed.

However, my experimental set of lifestyle activities for lowering my IOP still seem to be effective. Notice that I did a series of activities starting with playing with my dog (IOP measured at 2:16 PM) and continuing with weight lifting. They worked, and my IOP went all the way down to about 14. I did a little more work, and my IOP went up, then I did some more activiites and my IOP went down again. Then I had the business meeting and my IOP went way up.

 

Time	Left	Right	SD L	SD R	Comments
9:51	26.3	23.0	0.577	4.359
12:46	21.0	20.7	1.000	1.155
13:35	19.3	20.7	1.155	2.082	working intensely at computer
14:16	16.3	17.3	0.577	1.528	after playing with my dog and 5m of Bates long swing
14:27	17.7	16.7	1.155	0.577	after relaxation exercises
16:11	14.3	14.3	0.577	0.577	after weight lifting - 4 exercises only (10m workout). Measurements taken 5m after workout
16:31	17.0	17.7	3.000	0.577	after shower - but already thinking about work
17:34	18.7	19.3	1.528	2.082	business planning
17:48	15.0	16.3	1.000	1.528	after playing with my dog and few minutes of Bates long swing
18:38	17.7	19.3	0.577	1.528
0:34	24.7	24.3	2.517	1.155	after a stressful business meeting involving difficult financial discussions
0:42	18.3	20.3	1.528	3.215
0:43	18.3	21.3	3.055	1.528	repeated

I used 1 drop of Xalatan in each eye at bedtime, as usual.