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We detected a significant decrease in intraocular pressure over the course of relaxation training

Submitted by dave on Tue, 01/06/2009 - 7:39pm

 Training in relaxation and visual imagery with patients who have open-angle glaucoma:

http://www.springer content/y1017p1p 012m0654/

Abstract  This study investigated the effects of training in relaxation and visual imagery on the intraocular pressure (IOP) of patients suffering from primary open angle glaucoma. The treatment included a basic program (BP) of standard autogenic relaxation exercises and an advanced program (AP), in which patients received instructions and practice regarding special exercises in ocular relaxation and imagination of aqueous humor drainage. Twenty-three patients, aged 24 to 69 years, received assignment either to a training group or to a waiting-list control group. We measured IOP before and after each training session. We ascertained 24-hr intraocular pressure profiles during clinical assessments prior to the training, in the interval between the BP and the AP, and after termination of the training. We also performed the water drinking test to provoke maximum intraocular pressure levels, and patients completed psychological questionnaires of depression, anxiety, and physical complaints.

Results on short-term changes indicate only slight improvements of intraocular pressure levels [immediately] following each training session. However, during the course of the BP as well as of the AP, we detected a significant decrease in intraocular pressure. Twenty-four-hour profiles as well as the water drinking test also showed significant reductions of intraocular pressure across time. Medication dosage decreased for 56% of the initially treated patientsThe findings suggest that relaxation and visual imagery techniques can be beneficial in reducing elevated intraocular pressure levels in patients with open angle glaucoma.

Authors: Gert Kaluza and Ilse Strempel
(1)     Department of Medical Psychology, University of Marburg, Bunsenstraße 3, 35033 Marburg, Germany
(2)     University Hospital of Ophthalmology, Bunsenstraße 3, 35033 Marburg, Germany
Key Words  open-angle glaucoma - autogenic relaxation - visual imagination - group training

Dave's note: In support of the observations mentioned above, in our own research, we have found that intraocular pressure changes immediately following relaxation training are typically not reduced from values immediately prior to the session. However, there are a few special (advanced) techniques that I have found that can produce immediate reductions in intraocular pressure. It is in fact possible to reduce intraocular pressure after just one to 5 minutes use of a relaxation technique. (Again, that is an advanced technique that has to be learned after the basic techniques.)

The results of the research we are conducting at supports the conclusion that average daily intraocular pressure can be reduced over time by the daily practice of a relaxation technique. This average intraocular pressure reduction over time is the most important result of relaxation training. I have tested several biofeedback techniques as well as many relaxation techniques. By far, the most effective technique I have encountered is Serene Impulse. I'm sure there are other good methods for managing one's intraocular pressure, but Serene Impulse was the only one that met all my criteria. For me personally, it was the only technique that cracked my big challenge -- elevated intraocular pressure while sleeping (during in the early morning hours). (As many of you know, I decided to become a Serene Impulse instructor about six months ago, based on these intraocular pressure research results.)

I classify mind-body skills into three categories:

  1. biofeedback
  2. autogenic-type training (what I also call intellectual self-feedback)
  3. pure self-referral consciousness (which moves beyond the limitations of the intellect)

The 3rd category, pure self-referral consciousness, is the most effective and has the greatest healing capacity. It is also the most enjoyable and the easiest to do because it doesn't require any external equipment like biofeedback does. Serene Impulse is a "pure self-referral consciousness"-type of practice and that makes it far more effective than simple biofeedback. Of course anything one does to improve one's health is good, and biofeedback is better than nothing, as the research above (and below) points out.

I encourage all glaucoma patients to investigate the relationship between your stress levels, your emotions and your thoughts on one hand, and your intraocular pressure on the other hand. There is a clear relationship between our inner state of mind (which is where our stress arises from) and our eye pressure. It may not be obvious unless you have a tonometer and can perform self-tonometry. (And even then, finding the relationship involves careful scientific monitoring rather than haphazard casual IOP checking.) But our research shows that it is rare for a glaucoma patient not to show this close association between mind-content and eye pressure.

Below is one more abstract on related biofeedback research that a friend emailed me. I'm not really a big fan of simple biofeedback (for several reasons, including my opinion that it is the least effective mind-body skill), but these results do sound interesting and worth learning more about.

Biofeedback techniques in the treatment of visual and ophthalmologic disorders

http://www.springer content/kw8r3038 87n446q5/

Abstract  The literature on the use of biofeedback techniques in the treatment of visual and opthalmologic disorders is reviewed. Although this consists mainly of case studies, there is mounting evidence that biofeedback may be applicable to the treatment of strabismus, nystagmus, blepharospasm, elevated intraocular pressure, and myopia. Because of the success in applying biofeedback techniques in the treatment of other neuromuscular disorders, it is concluded that the use of these techniques in the treatment of blepharospasm and strabismus shows the most promise.
Writing of this manuscript was partially supported by NIMH Research Scientist Development Award, No. MH 00303 to Richard S. Surwit and by NIH Grant 1-RO HL22547 to Richard S. Surwit.

Authors Michael H. Rotberg and Richard S. Surwit
(1)     Behavioral Physiology Laboratory, Duke University Medical Center, Box 3926, 27710 Durham, North Carolina

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