I want to highlight three different approaches to performing home eye pressure monitoring (self-tonometry). Normally, I focus most of my attention in my blog on the approach I use. However, I thought it would be educational to contrast my approach with two other approaches. I'll discuss each one, but to get us started I would like to give each method a name as shown below:
- Dave's Method: research into non-medical factors, remove medication as a variable.
- Elizabeth's Method: minimize medication while keeping IOP at or below target level.
- Dr. Baumgarten's Method: maximize medication to minimize eye pressure fluctuation.
The key defining characteristic of my approach (Dave's Method) is that it is research-oriented with a focus on discovering non-medical factors that affect intraocular pressure. In order to achieve this goal, one thing I have to do is hold my glaucoma medication constant. Otherwise I would not be able to clearly see the effect of non-medical factors (such as stress management, exercise, diet, or supplements) in my data.
My long range goal is to eliminate all glaucoma medications and to substitute them with lifestyle factors such as Serene Impulse (an inner fitness technique for stress management), exercise and the other things I usually discuss on my FitEyes.com blog. With my focus entirely on non-medical approaches to managing intraocular pressure, I effectively remove glaucoma medication from any significant role in my research by holding it to a low and non-changing level.
With the influence of glaucoma medication neutralized, I then aggressively search for non-medical factors that influence intraocular pressure by monitoring my IOP frequently while also monitoring other physiological parameters such as heart rate variability (HRV), galvanic skin response (GSR), respiration rate, skin temperature and any others that are within my capabilities. I institute practices that are designed to alter the paramters I am monitoring and I carefully track intraocular pressure changes as a result of my experimental manipulations.
As far as I know, I am the only person taking this approach to self-tonometry. I welcome anyone else that is interested and I will be glad to consult with you to help you move forward with this approach.
Elizabeth is a long time member of FitEyes.com and she has almost two years of experience with self-tonometry. (If my memory is correct, she started self-tonometry in 2006.) She has had good success with her approach to self-tonometry and I have a lot of respect for what she, and others like her, are doing. Her goal is to use the minimal amount of medication while maintaining her intraocular pressure at or below her target IOP. She allows her intraocular pressure to fluctuate a bit and she mainly utilzes medication to keep the peak IOP under the maximum her doctor has recommended.
Elizabeth is not as interested as I am in conducting extensive research due to the demands of data collection, experimentation and analysis. (Most people are not, and that is understandable. Conducting experimentation and data analysis is not a requirement for participating in the FitEyes.com self-tonometry research project.) However, Elizabeth does look for trends she can discover by "seat of the pants" techniques. She has noticed some connection between what she eats and her intraocular pressure and these observations have been helpful to her. In this way, she is conducting informal self-tonometry research. She periodically contributes her IOP data to our self-tonometry research project and that has scientific value in the long term. Her informal observations have value to the rest of us as well. We can all discuss what she observes and, if we desire, we can follow up on her observations with further research -- whether formal or informal.
Elizabeth is quite happy that her self-tonometry allows her to maintain her eye pressure in an acceptable range on a minimal amount of medication. She does not require new discoveries or breakthrough new knowledge in order to derive benefit from her self-tonometry efforts. She reports that she has reduced certain glaucoma medications from daily (or even multiple daily) use to use every few days or even every few weeks while managing to maintain excellent intraocular pressure values. As I understand it, her doctor is happy with the results of her visual field tests and other tests.
Dr. Baumgarten's Method
Dr. Baumgarten is a true self-tonometry pioneer. He lives in Germany and he is a retired director of the Calibration Institute of Berlin. He is not a medical doctor - he is a glaucoma patient like the rest of us.
He has published an article on self-tonometry in a German magazine: Baumgarten D: Selbstkontrolle durch den Patienten. Der Augenspiegel. 2003; 10: 26-29
He also wrote the Ocuton S supplemental manual in German. The Ocuton S is the tonometer he uses. (Marcel owns an Ocuton S and he can comment on it in more detail if anyone has questions. But in short, Marcel prefers the AT555.)
Dr. Baumgarten, as an engineer, takes an engineer's approach to intraocular pressure management. As I understand it from conversations with Marcel, Dr. Baumgarten's goal is to maintain very tight control over his intraocular pressure and he has achived this through frequent self-tonometry and a very complex routine of glaucoma medication. Dr. Baumgarten checks his IOP on a regular schedule many times throughout the day and night. He sets his alarm to wake up at specific times during the night. He administers glaucoma medications at these times and does so in a manner that tightly regulates his intraocular pressure. He has followed this routine for more than ten years, including waking up (twice I believe) during the night each night to perform self-tonometry and administer glaucoma medications.
Dr. Baumgarten is a machine! I mean that in a complimentary way. I just do not have the discipline to follow such a rigid schedule 24 hours a day year after year. But Dr. Baumgarten, as a true engineer down to his core, has devised this engineering approach to self-tonometry that works for him.
One great feature of Dr. Baumgarten's program is the meticulous record keeping he maintains. This is one common feature in the way we both approach self-tonometry. I have not compared records with Dr. Baumgarten and I cannot say which of us have better records, but I doubt few others on the planet would eclipse either one of us when it comes to our IOP data. I encourage everyone participating in the FitEyes.com self-tonometry research to strive to maintain excellent records including not just IOP values but extensive notes about activities, mental and emotional state, and all the other factors we discuss in the self-tonometry research forum here at FitEyes.com.
Based on the existing scientific knowledge about glaucoma management, Dr. Baumgarten's approach comes close to the idea of allopathic medicine. He uses what seems like heroic effort to minimize intraocular pressure fluctuations through appropriate (and rather high, in my opinion) use of allopathic glaucoma medication. I think most medical doctors would be very comfortable with Dr. Baumgarten's approach to self-tonometry. However, Dr. Baumgarten's approach is more about IOP management than about research. (And I think most medical doctors would not want their patients conducting research anyway!)
Now that I have summarized these different approaches, I would like to comment further. No one approach is better than the others. Each approach is selected to fit the goals of the individual applying it.
Dr. Baumgarten's approach is commendable. Elizabeth's approach is moderate and probably very sensible. I suspect my own approach may be the most controversial. The intraocular pressure data I collected from careful experiements led me in the direction of studying the relationship between consciousness and intraocular pressure. The study of consciousness is not something most allopathic physicians are comfortable with. But that may be the least controversial aspect of my approach. I am a glaucoma patient and most doctors are not comfortable with their patients conducting medical research. However, I have a background in both medical sciences as well as statistics, so my situation is a bit different. My doctors have welcomed me into the research community and given me a lot of support. (And it certainly doesn't hurt that I have better tonometers than my doctors! That's one costly step I had to take in order to be taken seriously in the beginning stages of my work.) With excellent physicians supporting me in these research efforts together with the growing self-tonometry community here at FitEyes.com that provides support, I'm less of a maverick than I was when I embarked on this journey. That's a good thing. And fortunately, now that FitEyes.com exists, no one else needs to undertake self-tonometry research without some support. New self-tonometrists can benefit from all the expensive and time-consuming lessons others of us have learned through the school of hard knocks.
My approach to self-tonometry is all about discovering new knowledge and I actively experiment in order to achieve that goal. My eye pressure has been in a downward trend over the last couple years while I have not made any changes in my glaucoma medications. This downward trend is the result of applying the knowledge I gain through my active experimentation in self-tonometry. However, I do potentially subject myself to some extra risk in allowing my intraocular pressure to fluctuate more than it would under an approach like Dr. Baumgarten's.
That tradeoff is something I am willing to make. Dr. Baumgarten, with the approach described above, can reduce his intraocular pressure only through additional use of allopathic medications. I am not faulting his approach, and I do recognize that his is the more conservative approach. But the trend of decreasing intraocular pressure without extra medication that I'm seeing in my own data is something that can only be achieved with the discovery and application of new knowledge.
I have chosen to take the lead on experimenting to discover that new knowledge. As we move forward, hopefully others will be able to benefit from what I learn without having to take the same risk I take. For example, in order to prove the correlation between stress and intraocular pressure to my satisfaction, I had to sometimes allow IOP trends to play out without intervening with extra glaucoma medications. And my recent research into consciousness and intraocular pressure exposes me to amplified IOP fluctuations. I have found that the fourth state of consciousness holds great potential for managing IOP, but the power of this state of consciousness is such that incorrect mental techniques seem to amplify the elevations in my IOP. As I am discovering and refining new techniques for managing IOP, and experimenting in that vast frontier of consciousness, I do sometimes find that the things I'm doing raise my IOP. I first noticed this potential "side effect" of consciousness-altering techniques way back in 2006 when I wrote that Transcendental Meditation Increases My Intraocular Pressure. At that time I was shocked to see this effect and I did not understand it at all. Now I have a much more clear understanding of it through my program that merges research in consciousness with research in intraocular pressure.
Research in consciousness merged with intraocular pressure research is the heart of my research focus now -- and it is my real passion.