Useful info

Hey,
I also find Corneal Hysteresis interesting. However, I should point
out that most of the top glaucoma specialists are less enthusiastic
about it. Even the ones that have published positive research (and
given positive testimonials) seem much more reserved and cautious when
discussing it in private. Even so, I remain very interested in CH.
Have you had yours tested? In my case, the CH results were in line
with everything else I know about the health of my eyes. I felt it was
valuable to know my CH. I also think following CH over time would be
an excellent research project - especially if one can influence CH
through nutrition, etc.
If you get really serious about CH, please contact me. I have a
hypothesis that oxidative stress is a key foundational issue in
glaucoma and I also believe that CH may be indicative of oxidative
stress (at least in part). If you want to help fund some research, let
me know.
David

Dear All,
Attached is an article about corneal factors in measuring IOP I found very
interesting.
Small Pupil ( a glaucoma sufferer)

I wore a contact lens for low pressure caused by a bleb leak. don't know about
a contact lens simply to deal with low pressure.

Did anybody get a temporary contant lens bandaid for their eye since
the IOP was too low in the range of 3-5 and potentially causing vision
shifts. My understanding is that is is supposed to help after the ALT.
Trying to find out what is the downside since never wore contacts.

Lillian, I don't know the answer to your question, but I did want to tell you that there is a brand out there that doesn't have anything in it except pure lemon juice and I can't remember the name of it! Mary

Tom,
There is some evidence that flax oil is not good for men (our
prostates). I have switched to a pharmaceutical grade of fish oil
myself.
John

Hi,

I wonder if anyone has info on the effect of food preservatives such as sodium bisulfite and sodium benzoate daily on IOP or otherwise in glaucoma? Normally I avoid all preservatives, but I am trying to drink large amounts of lemon juice (for another health issue) daily. Yes, I could squeeze lemons... a lot of them daily but....So I bought one bottle of the juice, and notice that it has those preservatives. I could not find any relevant lit in Pub Med.

Thanks,

Lilian

Hi,
I am on Xalatan at nite and Timoptic in the morning. I have trouble
with dry eyes. I tried the flax seed oil and it does seem to help. I
take a tablspoon and night and a tablespoon in the morning. It took a
few weeks before I started to notice a difference.
Good Luck
Tom

That may be true. My insurance didn't even want to pay for the diurnal
testing my glaucoma doctor ordered, and that was just 8 hours at the
hospital (as an outpatient, though--between IOP readings I didn't have
to stick around).
-Deah

Hi Chris,
I use only Alphagan P. Ironically, it is supposed to contain a
gentler preservative (Purite) than regular Alphagan, but each of us
reacts differently. I hope the switch to the generic gives you some
relief. I do know Alphagan causes allergic reactions in a lot of
people. My eyes are red, dry, and sometimes itch, but it is livable
for me at present.
I have dry eyes in general (and have had for years). I use Systane,
but I was wondering if you had tried flax seed oil? My primary care
physician recommended it to me because a number of his patients told
him it helped them. It seems to be best to grind flax seeds and put
them in food, or use flax seed oil. It has helped me--I don't rely on
Systane as much.
Here is a link to a Wills chat about dry eyes in which flax seed oil
is recommended (unless you are on blood thinners).
http://willsglaucoma.org/supportgroup/20060628.htm
Good luck--I hope you get some relief from the redness/dryness soon.
Mel

hi everyone ...
this is a follow-up on the alphagan P
severe red eye/dry eye issue ...
i saw my doctor yesterday
and she suggested it could
be the preservative ...
i'm on lumigan and cosopt
in both eyes and on alphagan P
in only the left eye ...
it's only the left eye that gives
me problems ...
so she has put
me on the generic (brimonidine)
for 1 week in place of the alphagan
to see if this problem clears up ...
any other thoughts/suggestions ??
let's just pray this combo works !
this red eye/dry eye is killing me
no matter how much lubricant i use ...
thanks, chris

You'd have to check with your glaucoma specialist. I'm sure there'd also
need to be some hoops to jump through with your insurance too!
Sherry

Do they offer 24 hr IOP measurements here in the US? I have had
borderline IOP at single office measurements in the past, but have
recently noticed occasional eye aches and times when my eyeball
'feels' much larger than usual upon gentle touching (often at night
and in the morning immediately upon waking; are there any explanations
for this other than a higher IOP? I am extremely myopic). I think that
a single office measurement might easily miss spikes in pressure. I
know that in some countries in Europe, hospital stays with 24 hr
measurements are routine for diagnosis and treatment evaluation.
Thanks!

Jim - I believe that Dr. Ritch has previously commented that sleeping with the head elevated might reduce blood flow to the optic nerve. We do know that IOP is elevated with any posture other than an upright posture. (In this same issue note the comment about IOP in horses). However, the critical factor in glaucoma (particularly NTG) seems to be retinal perfusion, which is based on the relationship between blood pressure and IOP. Therefore, it is possible to make the wrong decision if only IOP is considered. For example, if elevating the head reduces both IOP and blood flow, it may hurt more than it helps. I don't know enough to offer you a definitive recommendation, but in my own case I have been striving for moderation. I make sure I use a fairly tall pillow but I stay within the range of a normal horizontal sleeping position (and I definitely do not elevate the head of my bed). On my blog I went into quite a lot of detail about various things I'm experimenting with to
keep my blood pressure higher and my IOP lower while sleeping . I'd love to hear what you think.
David
http://fiteyes.com/blogs/dave/

A note from the moderator: Lilian sent this to the list on the 14th and for some

Thanks Dr. Ritch, it would seem that elevation of the head
might be beneficial to Normal Tension Glaucoma patients.

Since elevating the head might help and seems very unlikely
to hurt, I will do so.

-- Jim Griffin,
Forest Hills, NY

"this study reports an intriguing relationship between change in IOP
from sitting to lying and progressive field loss in NTG. If this work is
confirmed by others using more robust research methodologies we
may find ourselves recommending the same therapy for progressive
NTG as prescribed for esophageal reflux -namely elevation of the head
of the bed!"

Do you have a Lions Club Eye Clinic in your area? They will do it for free.

Cheryl

can anyone help me i got to have another test and pressure check.i
don't have the money is there anywhere i can get help to pay for it.

I have tried it to help with allergies and my sleep apnea, but it didn't seem to help with those problems. Not sure how it would affect eye pressures.

Cheryl

Hi,
I just had my first post-diagnosis VFT. No progression, and my
pressures were also lower--17/19. I started at 22/23. So the news was
good, and I am grateful.
In one of the Wills chats, Dr. Wilson stated he has many patients who
still have "reasonable vision" after 30-40 years of using drops.
Exactly how would "reasonable vision" be defined by a glaucoma
specialist, if there is a standard?
Here is a link to the chat, in case anyone is interested:
http://willsglaucoma.org/supportgroup/20031001.php
Mel

I also use Alphagan P in one eye only, on top of Lumigan and Trusopt
in both eyes. I haven't noticed more redness, but that eye is pretty
dry in the morning when I wake up. I actually keep that eye closed for
a little while because it hurts to open it at first.
There are two strengths of Alphagan P; if you are using the stronger
one you might find the more dilute version less irritating.
-Deah

Since no one else answered you, I just wanted to say that while
increased cupping is not a good sign, you can't really tell where you
stand from the cupping ratios themselves. Someone with myopia could
have a cup to disc ratio of .7 and that would be normal for that
person, no glaucoma. On the other hand, someone without myopia could
have a c/d ratio of .4 or .5 and have glaucoma. If the ratios are
increasing, as you already know, that probably shows some progression.
-Deah

hi ...
insight is welcome here ...
i'm on cosopt 2x a day in
both eyes and lumigan 1x a day
in both eyes ...
i'm also on alphagan P
3x a day in my left eye only ...
i notice when i wake up
in the morning that my left eye is
really really really red, while my right
eye is fine/ok ...
i also notice that my left eye is really
really really dry while my right eye is
fine/ok ...
do folks think the alphagan P is
causing this dryness and red
eye problem ??
the red eye dissipates over the day
until it's almost gone by evening ...
but in the morning it's beet red ...
anyone else experience this ??
dr. ritch ??
thanks !!
chris

Hi Chris,

I experienced the same issues as you with Alphagan P. Like you, I'm also on Cosopt, Xylatan and had Alpha-P replaced with Pilocarpine. My dr. didn't think I'd be able to tolerate the 4 x day with the pilo, nor the darkness it creates, but I much prefer it to the red, itchy, achy eyeballs. The pilo restricts your pupil such that seeing in dark areas does become more difficult, but I've adjusted to that.

Carol

Richmond, VA

Hi everybody,
Just got the results of the optic nerve photographs. The ratio is
right eye, vertical 0.5, horizontal 0.4. Left eye is vertical 0.7 and
horizontal 0.5. There is an increase now of one point in the right
vertical and two in the left vertical from what it was eight months
ago when I did the same test. In the last eight months, seven were
without any treatment so the increase could have happened during that
time. In the eighth month I was prescribed Timolol which has dropped
the pressures from 24 to 20 in the left and 22 to 18 in the right.I
see my doc. a month from now. I know the higher readings are bad news
but how bad? Any comments or information would be appreciated during
this waiting time. Thanks.

Hello Dr. Ritch,

Thank you so much for taking from your busy time to post the diagrams and the subsequent explanation later the same day. Both the diagrams and the explanation are extraordinarily clear and helpful. I have read and re-read several times, and although I had been doing punctal occlusion per your video (in more recent years, I had no idea this existed when I was diagnosed w/NAG in 1998), these diagrams and your explanation really are so helpful. I did not respond to your e-m on 3/18 b/c was post-op (not eyes) and not sitting at computer long.

I am wondering if there is a way that when people sign up to become part of this virtual group they can automatically get those 2 e-mails (probably you could combine into one). When people are new to glaucoma, besides all the anxiety, it is not possible often to ask about something not known to exist, e.g. punctal occusion technique. If no one at the time is asking (as I did recently for other health reasons) someone could be reading these messages for months and not see this topic. I also wonder if both the diagrams and the someone at Unite for Sight (with your help) might simplify the language to be used in numerous countries where that fine organization works. Is it ok if I forward your two e-m's on this topic to Jennifer Staple and tell her she may contact you?

Again, grateful for your time, care, thoughtful concern.

Lilian

The SOLX gold shunt is not a primary procedure. The SOLX laser study is for patients with failed argon laser trabeculoplasty.
On 3/20/07 11:50 AM, "kathrynjundt" <jundtk@...

I read most of the posts and back in November someone asked about the
above. Dr. Ritch put a link up about it.
Has anyone participated in this study and had the implant?
Dr. Ritch, you are listed as a sub-investigator at the Solx site,
www.solx.com
I am very near having to try surgery as the medications are failing and
SLT's are not doing much either.
Any info would be much appreciated.
Kathy Jundt

Robert Ritch, MD
Professor of Clinical Ophthalmology
Chief, Glaucoma Service
Surgeon Director
The New York Eye and Ear Infirmary
310 East 14th Street
New York, NY 10003
Medical Director and
Chairman, Scientific Advisory Board
The Glaucoma Foundation
Private - Tel: 212-673-5140
Director of Intelligence: Karen Cheifetz
kcheifetz@...
Patient Appointments - Tel: 212-477-7540
Fax: 212-420-8743
e-mail: ritchmd@...
http://www.glaucoma.net
http://www.nyee.edu

I read most of the posts and back in November someone asked about the
above. Dr. Ritch put a link up about it.
Has anyone participated in this study and had the implant?
Dr. Ritch, you are listed as a sub-investigator at the Solx site,
www.solx.com
I am very near having to try surgery as the medications are failing and
SLT's are not doing much either.
Any info would be much appreciated.
Kathy Jundt

In the past I would sometimes see halos around lights , they were
rainbow coloured and would last anywhere from 5 minutes to a couple of
hours. Recently I've been seeing halos again but now they are a bright
orange and my eye goes red . I blink and it can go away and blink
again and its back. I'm on Cosopt and Xalatan and have a check up in
May. Has anyone else experienced seeing the same type of halos?
Dora

------ Forwarded Message
From: "Kwon, Young" <young-kwon@...
Reply-To: "Kwon, Young" <young-kwon@...
Date: Sun, 18 Mar 2007 16:10:57 -0500
To: agsocietynet <agsocietynet@...
Conversation: Eye Care Website
Subject: Re: Eye Care Website
A little more than a year ago, my glaucoma colleagues (Drs. Emily Greenlee and John Fingert) and I, here at the Univ of Iowa, started writing a 12-chapter book titled, "A Patient's Guide to Glaucoma." Rather than just writing a traditional paper book, we teamed up with an internet publishing company and decided to put the entire book on the internet, whose content is searchable by Google search engine. Our original intention was to provide basic glaucoma information to our own glaucoma patients through the internet, but we felt it was fine to share it with anyone else who may find it useful on the internet.
We just finished our last chapter and uploaded it a few weeks ago. Eventually, we will also publish the book in a traditional soft cover book for anyone wishing to purchase a copy of own. As such, all of our figures and tables are original and copyrighted. But in the meantime the entire book is freely available online if anyone wishes to look up any specific information about glaucoma.
You can see/read the book at:
www.medrounds.org/glaucoma-guide
I hope it is helpful to you and your patients.
Young H. Kwon
Addendum: I should mention that I helped start the internet publishing company and therefore, have a financial interest in the company as well as (eventual) sale of the book. Nevertheless, the entire content of the book remains open and free to the public.

Thanks Dr. Ritch! I really liked the pictures on the Indiana.edu site!
Sherry

http://www.medrounds.org/ocular-pathology-study-guide/2006/02/lacrimal-excretory-system-human.html
http://www.indiana.edu/~pietsch/eyediagram.html
And this is good but the diagram from this page didn't copy
http://www.womensweb.ca/health/eyes/
Tear film
As mentioned, the conjunctiva is part of a more complex system that works to keep the eye moist. Tears help in this. Not only do they help keep they eye moist, but tears also help nourish the front of the eye. They provide protection from injury and infection by flushing away debris and foreign particles, and they create a smooth surface for light to pass through the eye.
Tears are produced by tiny lacrimal glands located toward the outer edge of the eye, just below the eyebrow. Tear film is composed of three layers: oil, water, and mucus. The bottom mucus layer, produced by goblet cells in the conjunctiva, anchors the tear film by helping it adhere to the eye. The top oil layer acts as a sealant and prevents evaporation of the water layer beneath.
Each time you blink, your eyelids spread the tear film evenly across the surface of your eye. Blinking forces tears into tiny drains (called puncta) found at the inner corners of the upper and lower eyelids. From the puncta, the tear film travels via the upper and lower canaliculus and empties into the lacrimal sac. The lacrimal sac, which connects to the nasal passage, drains into the nasolacrimal duct. It's because of this connection between the eye's tear production system and the nose that your nose runs when you cry and that you can sometimes taste eye drops as they drain from your nasal passage into your throat.
When people develop problems with the quality of the tear film that lubricates the eye, they may develop a condition known as Dry Eye Syndrome.
On 3/12/07 4:14 PM, "dshale1" <Dshale1@...

The problem I have always had with this video is that it just shows a
finger in the corner of the eye. Since her finger covers the area, I
can't really see precisely where she is pressing. I have been told we
are supposed to press on the bump at the juncture of the eyelid and
side of the nose. From the drawing Lilian found, I wonder if a little
upward pressure is best. You really can't tell something like that
from the video.
-Deah

Grace,
I don't know anything about iridotomy, but I see something similar with the
trabs! I can see round "holes" in each eye under certain lighting
conditions. It's bizarre <g
Sherry

I just had an Irodotomy done 2 weeks ago and when I look at bright
lights, I see a shadow where the hole was done. My doctor says this
is normal. Since I need to have the other eye done, could you please
tell me a little more about this?????
Thank you,
Grace

Hi,
I read on the internet that the neti pot or saline nasal irrigation is
a practice which is beneficial for glaucoma. Has anyone else tried this?
Dot

Hi Deah,

I tend to use home blood pressure monitor more often than my ProView (sometimes both at same time) to get a general sense of my IOP. Like Sherry, I let my good GS use the best to monitor me in his office.

There are many links on the relatioship of BP and IOP. For example:

http://bjo.bmj.com/cgi/content/abstract/89/3/284

and

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3073175&dopt=Abstract

I wonder what Sherry or any of you found about the relationship of BP and IOP in Open Angle Glaucoma?

Lilian

hi ...
i have POAG and am on maximum
drop medication ...
cosopt in both
eyes 2x a day ...
lumigan in both eyes 1x a day ...
alphagan in my left eye
3x a day ...
my pressures are around 16 to 17
in my left eye and 13 to 15
in my right eye (i've had a trad in that eye) ...
how does one know if
eliminating a drop will change pressure
since these drops have accumulated
over the years ... (ie, dr says let's
add a drop ... that's how i've ended
up with this regimen ...) ...
does going cold turkey
for 2 weeks and then starting over
pose a risk ... i'm going
to talk to my doc about this in
a couple of weeks when i see
her but wanted folks thoughts on this ...
thanks !!

Hi Patrick
Nice to hear from you after a long silence.
Sorry to hear that your NTG is worsening.
Please keep us posted.
BTW I have already stopped using drops until I 'll go to see another eye
doctor.
Mee
Ooi Patrick <patrickooi03@...
Hello Meelan,
Long time no write!
From what you wrote (Drops for IOP) I don't think you've glaucoma. I wouldn't
waste the money on Xalatan if I were you - they're not cheap!
Just giving you an update of my condition. Had my check-up and VFT with my
optham today. The VFT showed that my NTG is worsening. My IOP was around 11-12
(quite low). Given my deterioration, my doc recommends that I should see the
top optham in National University Hospital in Singapore. She wouldn't say if
they can offer better treatment but she felt maybe bringing down my IOP to 5-6
would be even better, but that would probably require a surgery. Well, already
made an appointment for a day in April and let's hope something good may turn
up. My doc also suggests that I change from Betagan to Betoptic which is
supposedly more effective. This will be administered twice a day - morning and
evening. I'm also on Xalatan before I go to bed. My doc believes the cause
for my NTG is due to reduced blood flow to my eyes and she even suggests that I
put on a respirator mask when I sleep to ensure sufficient oxygen gets to my
brain! In the meantime I'm scheduled to spend 24
hours in the hospital next week to allow them to monitor the change in my IOP
on an hourly basis! Boy, am I in trouble both physical and financial (have no
insurance)??
Anyway, take care all you folks out there!!

I have developed some sensitivity to very bright light from all the
eyedrops (I'm on Lumigan, Trusopt and Alphagan) but not anything
nearly as severe as Marc describes. It does not sound like something
related to glaucoma to me, or at least not open angle glaucoma.
-Deah

I was diagnosed with Glaucoma 3 years ago and have been taking drops
religiously. I did not see any deterioration in my vision, in fact,
never used glasses. Then last year, pressure in my right (worse) eye
started going up again from 19 to 22. I decided to bite the bullet
and get the surgery done in Dec.
After the surgery, my problems have multiplexed. My eye has been
turning red, irritated and sensitive to light. I was told that this
may be due to dryness. So using dry eyes drops.
Pressure in my left eye has started going up... so I told her to
stop all drops and start fresh (body chemistry has changed).
Finally, she let me drop Alphagan-p and Travatan. Guess what,
pressure was better just using one drop, Timolol.
But the BIG PROBLEM is that I am not seeing too well especially
through the inner corner of my eye and my IOP is 5-6. Now my
Glaucoma specialist keeps saying that all went well with my surgery
and this is my 'normal' vision due to Glaucoma advancement. I feel
that something did not go right for me to be losing my sight after
surgery. BTW, I go to Palo Alto Medical Foundation in bay area. I am
going for second opinion but I am REALLY getting nervous.....
I can meet with people who had surgery and can tell me what to
expect.
thanks much
Indu

Hello Meelan,
Long time no write!
From what you wrote (Drops for IOP) I don't think you've glaucoma. I wouldn't waste the money on Xalatan if I were you - they're not cheap!
Just giving you an update of my condition. Had my check-up and VFT with my optham today. The VFT showed that my NTG is worsening. My IOP was around 11-12 (quite low). Given my deterioration, my doc recommends that I should see the top optham in National University Hospital in Singapore. She wouldn't say if they can offer better treatment but she felt maybe bringing down my IOP to 5-6 would be even better, but that would probably require a surgery. Well, already made an appointment for a day in April and let's hope something good may turn up. My doc also suggests that I change from Betagan to Betoptic which is supposedly more effective. This will be administered twice a day - morning and evening. I'm also on Xalatan before I go to bed. My doc believes the cause for my NTG is due to reduced blood flow to my eyes and she even suggests that I put on a respirator mask when I sleep to ensure sufficient oxygen gets to my brain! In the meantime I'm scheduled to spend 24
hours in the hospital next week to allow them to monitor the change in my IOP on an hourly basis! Boy, am I in trouble both physical and financial (have no insurance)??
Anyway, take care all you folks out there!!

Meelan Lam <meelanlam_18@...

I have been using Xalatan since Nov. 2005.
During my last visit to my doctor 2 days ago, my IOP is 15.
He confirmed that I don't have any optic nerve damage and I also have 3 VFT which comes out normal.
But I was always thinking that I had NTG and also a slight optic nerve damage.(I don't know whether there were misunderstanding somewhere or not...but as far as I can recall, he confirmed me when I asked him about it)
Now he is telling me to continue to use drops till the end of this year.
He will then stop the drops and see the outcome.
I have been given drops right on my first visit when my IOP was 21.
I'm wondering why could my doctor not suggest me to stop right now instead of continuing to use the drops till the end of this year.
Thanks for any feedback
Mee

When you are in the hospital for the hourly IOP check, see if you can
perform some activities similar to those you do in your daily life. For
example, if you conduct business over the telephone, try to schedule an
important business call before one of the hourly IOP checks. See if you
can replicate situations from your daily life in the hospital -
particularly any activities that elicit strong emotions such as anxiety,
frustration, fear, etc. If you have a stressful job or family life, a
relaxing stay in the hospital will fail to pick up any influence of
those real-life activities on your IOP. If you can't do any real-life
activities, try to have a visual field test right before one of the IOP
checks - preferably in the early morning hours.
As people on this group have pointed out, even the thickness/height of
your pillow can make a big difference in your IOP while sleeping, so try
to replicate your at-home situation closely.
BTW, if your stay in the hospital will cost your more than about
US$3000, why don't you consider purchasing a TonoPen and doing the 24
hour IOP monitoring at home
<http://fiteyes.com/blogs/dave/2007/01/14/How-To-Measure-Your-IOP-At-Hom\
e-And-Change-the-World-Too
more accurate because of the factors I mention above. Plus you can
repeat it more than once at no extra cost.
Would you consider sharing your 24 hour IOP results on my blog?
Good luck.
David
http://fiteyes.com/blogs/dave/ <http://fiteyes.com/blogs/dave/

As some of you may know, I was recently diagnosed with glaucoma. I
have been having the sensation of light sensitivity recently. Today
for example it lasted all day, whether indoors working on the
computer, or at the gym on the treadmill, or driving around town, it's
the sensation of pain at the back of my eyes as though someone is
shining a bright flashlight in my eyes. Does this sort of sensation
go along with glaucoma or does it sound like something else?
Thanks,
Marc

It could be the drops, I've been experiencing something similar with Cosopt

Dora
lotsaa <lotsaa@...

As some of you may know, I was recently diagnosed with glaucoma. I
have been having the sensation of light sensitivity recently. Today
for example it lasted all day, whether indoors working on the
computer, or at the gym on the treadmill, or driving around town, it's
the sensation of pain at the back of my eyes as though someone is
shining a bright flashlight in my eyes. Does this sort of sensation
go along with glaucoma or does it sound like something else?
Thanks,
Marc

Thank you all for the replies.
Marc

If you don't have optic nerve damage, you don't have glaucoma. If I
were you I'd ask your doctor why he has you on glaucoma eyedrops at
all. If you had an IOP reading of 21, that is only high-normal and the
great majority of people with high IOPs never develop glaucoma anyway.
Are you seeing a glaucoma specialist? You cannot have normal tension
glaucoma if there is no optic nerve damage. NTG means the optic nerve
is being damaged despite IOP's in the normal range.
-Deah

I have been using Xalatan since Nov. 2005.
During my last visit to my doctor 2 days ago, my IOP is 15.
He confirmed that I don't have any optic nerve damage and I also have 3 VFT which comes out normal.
But I was always thinking that I had NTG and also a slight optic nerve damage.(I don't know whether there were misunderstanding somewhere or not...but as far as I can recall, he confirmed me when I asked him about it)
Now he is telling me to continue to use drops till the end of this year.
He will then stop the drops and see the outcome.
I have been given drops right on my first visit when my IOP was 21.
I'm wondering why could my doctor not suggest me to stop right now instead of continuing to use the drops till the end of this year.
Thanks for any feedback
Mee

1. Save the whales. Collect the whole set.
2. A day without sunshine is like.... Night.
3. On the other hand, you have different fingers.
4. Remember, half the people you know are below average.
5. He who laughs last thinks slowest.
6. Depression is merely anger without enthusiasm.
7. Support bacteria. They're the only culture some people have.
8. A clear conscience is usually the sign of a bad memory.
9. How many of you believe in psycho kinesis?... Raise my hand.
10. OK...so what's the speed of dark?
11. When everything is coming your way, you're in the wrong lane.
12. Everyone has a photographic memory. Some just don't have film.
13. How much deeper would the ocean be without sponges.
14. What happens if you get scared half to death twice?
15. I couldn't repair your brakes, so I made your horn louder.
16. Why do psychics have to ask you for your name?
17. Inside every older person is a younger person wondering what happened.
18. Just remember--if the world didn't suck, we would all fall off.
19. Light travels faster than sound. That is why some people appear bright
until you hear them speak.
20. Life isn't like a box of chocolates.... it's more like a jar of
jalapeno's.
What you do today might burn your buns tomorrow.

------ Forwarded Message
From: Mark Latina <mark.latina2@...
Date: Sat, 10 Mar 2007 13:14:26 -0500
To: Robert Ritch <ritchmd@...
Subject: RE: Anyone have concerns re glaucoma? Comments?
Bob,
Yes, this could become an increasing problem. Recently, I have had several patients tell me their insurance will not cover glaucoma because it is an existing condition for them. THe legislature may need to get involved.
THanks
Mark Latina, M.D.

Hi Marc,
I have been recently diagnosed with high IOP - 24 in
the right eye and 22 in the left. The doc prescribed
Timolol 0.5% drops - one in the morning and one at
night for both eyes. He also showed me how to press
down at the nose after instilling the drops to prevent
absorption into the body. I have been just fine with
Timolol and the one month exam showed a drop of
pressure to 20 and 18. I have had no side effects at
all from Timolol. Before Timolol the doc prescribed
Lumigan which I used for just one time. My face was
swollen like a football, eyes swollen shut and fiery
red. I felt terrible and that was the end of Lumigan
use for me. Hope this info. is of some reassurance and
help re. Timolol.

Hi,
I am 40, and was recently diagnosed with glaucoma in my left eye. My
iop's were about 22 in both eyes. Travatan brought my iop down to
about 19 in my left eye, but the opthamologist was not satisfied with
that (she wants to see iop down to 15) and therefore prescribed timorol
0.5% gel one drop nightly. I tend to have anxiety attacks when trying
out new medicines due to fear of having negative side effects from the
meds. I had no real problem with travatan, but I think the reading I
did on timorol, in that in can affect the cardiovascular system, has
gone to my head and has made me feel nervous about this med. I've seen
2 glaucoma doc's and they both concurred that I should start adding the
timorol to my travatan regimen.
So - questions:
1) has anyone tried timorol, and if so, did you have any unpleasant
side effects or not?
2) I recently read a recent study that said that there is a 0.1%
timorol gel that is as good as the 0.5% timorol aqueous solution but
with less side effects. I found that confusing since I thought that
the one I take is 0.5% gel, not 0.5% aqueous (my medicine box
says "timorol mal gel 0.5%" . Can anyone shed any light on this?
3) Are there any glaucoma regimens that anyone knows of that are
effective but that have a better safety profile than timorol?
thanks,
Marc

VIEIRA, Geraldo Magela, MD, Fax: 55-61-346-0923; fax home: 244-8173; office: SGAS 915 - Conj. B - Bloco D, Salas 306/307/308 - Ed. Office Center, CEP 70.390-150 - Brasilia - DF; gmvieiramd@...
On 3/9/07 8:32 AM, "Lilian Rosenbaum LCSW-C, Ph.D." <ylrosenbaum@...

Hi David,
Question: do you focus on your breathing while doing weights, and does that make a difference in your experience? I will study the paper Dr. Ritch kindly forwarded to us. I have been doing the bench press and the pull down, and always focus on never (always/never) holding my breath even a few seconds. As Sherry said, some of us have osteoporosis (and other issues), but I never ignore Dr. R and will study the paper next week when I am recovering from surgery (not eye surg).
Best,
Lilian

Why don't you contact Dr Vieira, who is writing the papers

Thanks Dr. Ritch! Am I reading this correctly that none of the subjects had
glaucoma? Would you expect the results to be the same with people who have
glaucoma?
that's the next study
I would suppose that light weights for general conditioning would be ok?
Women are encouraged to do some weight bearing exercises to help prevent
osteoporosis.
OK
The study would make me quite leary of weight lifting - or any activity that
involves the Valsalva maneuver - if I had elevated pressures to begin with!
me too
Sherry

Hi David,
Question: do you focus on your breathing while doing weights, and does that
make a difference in your experience? I will study the paper Dr. Ritch kindly
forwarded to us. I have been doing the bench press and the pull down, and
always focus on never (always/never) holding my breath even a few seconds. As
Sherry said, some of us have osteoporosis (and other issues), but I never ignore
Dr. R and will study the paper next week when I am recovering from surgery (not
eye surg).
Best,
Lilian

Thanks Dr. Ritch! Am I reading this correctly that none of the subjects had
glaucoma? Would you expect the results to be the same with people who have
glaucoma?
I would suppose that light weights for general conditioning would be ok?
Women are encouraged to do some weight bearing exercises to help prevent
osteoporosis.
The study would make me quite leary of weight lifting - or any activity that
involves the Valsalva maneuver - if I had elevated pressures to begin with!
Sherry

I agree that very heavy weights especially with bad teqnique lying flat on a bench can increase IOP . Sari was enquiring about lifting 4lb dumbells which I doubt would do her any harm.

Dora

Weight lifting is very beneficial for me and believe that it helps my glaucoma. Exercise in general improves circulation, general health and state of mind. Weight bearing exercise improves muscle tone therefore improving metabolism not to mention the benefit it has on the bones decreasing the chance of osteoporosis. Technique and proper nutrition also plays a major role, so I would recommend anyone who has never lifted weights to be monitored regularly and keep the weights light.

Hope this helps Sari : )

Dora
sari <wsaber@...

I saw your name on the article I found in Archives of Ophthalmology on weight lifting and IOP. I am doing a short series of
exercises with dumbbells that weigh 4 lbs each. I make a point of remembering to breathe throughout. I'm trying to rebuild
the muscles of my arms. I have terminal glaucoma in my right eye apparently due to high episcleral venous pressure. I had a
trabeculectomy last May. I've recovered nicely but I'm still losing the remainder of my field of vision in that eye.
I'll ask my glaucoma specialist during my next visit but til then can I continue my 10 minutes of exercise, 3 times a week?
thanks,
Sari

That's no problem. Here's the paper. I think I posted it once previously
On 3/8/07 3:11 PM, "sari" <wsaber@...

I saw your name on the article I found in Archives of Ophthalmology on weight lifting and IOP. I am doing a short series of
exercises with dumbbells that weigh 4 lbs each. I make a point of remembering to breathe throughout. I'm trying to rebuild
the muscles of my arms. I have terminal glaucoma in my right eye apparently due to high episcleral venous pressure. I had a
trabeculectomy last May. I've recovered nicely but I'm still losing the remainder of my field of vision in that eye.
I'll ask my glaucoma specialist during my next visit but til then can I continue my 10 minutes of exercise, 3 times a week?
thanks,
Sari

Robert Ritch, MD
Professor of Clinical Ophthalmology
Chief, Glaucoma Service
Surgeon Director
The New York Eye and Ear Infirmary
310 East 14th Street
New York, NY 10003
Medical Director and
Chairman, Scientific Advisory Board
The Glaucoma Foundation
Private - Tel: 212-673-5140
Director of Intelligence: Karen Cheifetz
kcheifetz@...
Patient Appointments - Tel: 212-477-7540
Fax: 212-420-8743
e-mail: ritchmd@...
http://www.glaucoma.net
http://www.nyee.edu

Dear Sari

Thank you for the welcome words, I am just hoping with IOP 30 it is not too long to wait 3-4 months. I try to keep a positive attitude. :)

Julie

I saw your name on the article I found in Archives of Ophthalmology on weight lifting and IOP. I am doing a short series of
exercises with dumbbells that weigh 4 lbs each. I make a point of remembering to breathe throughout. I'm trying to rebuild
the muscles of my arms. I have terminal glaucoma in my right eye apparently due to high episcleral venous pressure. I had a
trabeculectomy last May. I've recovered nicely but I'm still losing the remainder of my field of vision in that eye.
I'll ask my glaucoma specialist during my next visit but til then can I continue my 10 minutes of exercise, 3 times a week?
thanks,
Sari

Dear Julie,
It is great that your optic nerve and your field of vision are both normal.
Keep the group aware of what is going on step by step.
We all have a LOT of experience with your situation and we can help you be vigilant about your treatment
plan. We can give you information and explanations.
There is still a lot of hope that you can keep your situation stable.
I missed out by not knowing about this group when my situation was still as good as yours.
I encourage you to share share and share. We never
get tired of listening and we are great advice givers.
The final decision is always yours but there is a lot of glaucoma wisdom here. Use it.
Keeping your spirits up is an integral part of staying well.
love,
sari

I think I am one person who is NOT affected by stress, regarding my IOP: but then, I have normal tension

glaucoma so my pressures are not unusual.

The reason I believe this is that once right before a laser repair of a retinal tear (something I was TERRIFIED about) I had a pressure of 13 in one eye and 14 in the other.

Laurie

Julie,
Could you ask Dr. Somkiat Athikomkullachai to comment on your experience with Valium and IOP? You could post a comment to him here (where he posted as somkaitoo). I think a lot of us would like to see if he provides any additional insight. That might also help us decide if he is "for real."
I hope I don't sound like a broken record, but if SLT (or trab) is your only option now and you have to wait 6 months, why not monitor your eye pressure at home and see if you find things you can do to lower it. My IOP has proven to be very responsive to simple things I can do at home. I would never have known this if I had not started monitoring my IOP at home.
Regards,
David
http://fiteyes.com/blogs/dave/

So true. I did vote a little while ago when I got her announcement. I attended
one of the large meetings in Boston in 2005. She is truly remarkable,
Lilian

I went and voted for her. She, and all these people, are very
impressive! However, the voting process was a bit complicated. I
visited about a dozen pages before I was able to place the vote.
David
http://fiteyes.com/blogs/dave/

Jennifer Staple is an incredible young lady who has done much in the fight against blindness around the world! Peruse her website and then go to Brickawards to vote!

Thanks,
Sherry

I went very stressed out for my appointment , 4 weeks ago my IOP was 30, 30 and I used. taking Travatan and timoptic. I was adding Trusopt to one eye.Today I took valium and walked 1 hour before my appointment, but the reading were the same.30 29

I am on drops for 20 years and they either not helping or I am allergic to it. He is sending me to another Glaucoma Specialist to perform SLT and he is not optimistic it will help and then need a TRAB. My field vision are normal and no appearant damage on my optic nerve.

The problem in Canada that it takes 6 months or longer wait to get an appointment. It looks like I will need a trab even with good optic nerve.:(

Julie

David I love your philosophy and your blog on

Embrace Evolve Exceed To Overcome Glaucoma

You express it so well, yes stress is a part of everyones life from the moment we take our first breath and the truth is we are all individuals with different lifestyles , different needs and a different perspective on the world.

As I have said before I have noticed in the past that stress has raised my IOP but that's not to say that it applies to everyone.

What is stress for one is not stress for all and that is why we all have such conflicting opinions.

Glaucoma to most means blindness and causes not only stress but anxiety and depression. Glaucoma to me has given me strength to overcome obstacles . I too believe that it has made me a better person.

There is hope for us all we are after all empowered with knowledge. We should use this knowledge to the best of our ability.

I believe the only "miracle cure" is our inner self .

I no longer fear glaucoma, therefore I have already won.

" A friend is a second self"

- Aristotle

Dora

First, many thanks to this group. In the couple months I've been back on I have benefited greatly.
Today I went to my retinal specialist. Part of his exam is taking my pressures. (Indeed, I have been relying on the work of retinal specialists for my glaucoma checks and medications for about ten years, to my embarrassment.)
Stress. OK, it was unbelievably cold in NYC. Just walking to where I could get a cab, I felt as if my hands were getting frostbite. When I finally was able to get a cab to stop for me and my guide dog, the driver was playing his radio very loudly.
I don't care for that in general and technically it is not allowed but I save my trips to Taxi and Limousine court for things I can prove. Please don't be offended, anyone who might, but he was playing Rush Limbaugh's call-in show, which was making my blood boil.
(I have friends who listen to him, but they do away from my presence.)
When I got there, through very heavy traffic, I did feel stress.
Here's what I did:
1. relaxation exercises that help put a positive thought in one's system. I kept my eyes gently closed in the waiting room and did these over and over.
2. tried to help an 89-year-old man sitting next to me with concerns he had about his vision loss through macular degeneration. That is one eye problem I don't think I have but the way I handle things -- talking books, computer with speech, etc. -- applied.
I have found, primarily in recovering from cancer, that helping others is the biggest possible help to me.
So, I went in and had the pressures taken and they were very good, for me: 14 in the better eye and 19 in the other. (When I saw the doctor I didn't care, for about whom I posted in January, the pressure was in the high twenties in both eyes.)
Who knows. It could have been a matter of diurnal curves. The pressures were taken a couple hours later than when I usually have them done, which is eleven AM. But I have to think the relaxation efforts cut down on some stress that surely would not have been good.
Take care,
David and Xia
**************************************
AOL now offers free email to everyone. Find out more about what's free from AOL at http://www.aol.com.

Timolol is the only eyedrop I don't use--I'm on Lumigan, Trusopt and
Alphagan. Yes, they can make your eyes more sensitive to light.
When I had my last retinal exam by the retina specialist, using
scleral depression and an extremely bright light to examine the edges
of the retina, it hurt so much the tears were streaming down my face
and I didn't think I could stand it much longer. The doctor said he
was sorry, but it was necessary, and he said it doesn't damage the
eyes. I did leave with a colossol headache, however.
-Deah

Hi everybody! Three months ago I did a retinography exam and had a
repeat yesterday. The flashing light as the camera took the photos was
almost unbearable. The first time wasnt so bad. This time, perhaps
because of the Timolol drops I am using my eyes seemed to be
hypersensitive to the light. Has anybody felt just blinded by the
flashes as the camera photographs the optic nerve and back of the eye?
I hear the light shining into our eyes is necessary as its the only
way to illuminate the back of the eye and get the pictures. My
question is, can this light/flashes of whats called a fundus camera,
damage our eyes in some way? Is that possible? Any opinions would be
welcome. Thank you. Incidently, its now 24hrs after the procedure and
my eyes feel alright and normal. Soon after they felt terrible.

Hi Annika,

In the United States Gingko Biloba is sold
over the counter. In Germany (and perhaps Finland)
I understand you need a doctor's
prescription to buy it.

*

I heard that in Germany gingko biloba is the No. 1 largest selling prescription drug.

Interesting.

If you buy it over the counter in the US, be sure to look at the label. You should see two numbers:

At least 24% gingko glycosides (flavinoids)

At least 6% terpene lactones.

These are the two most important active ingredients in gingko biloba.

earle

*

(I am an engineer and not a health-care professional.)

And if you're thirsty, you're already dehydrated!
You're so correct - it's the amount of water you drink at once that affects
the eye pressure.
Sherry

Sari,
That's *so* true! Even third-world country tribal people have a certain
amount of stress to deal with in their lives - it's just different from the
stress those of us in "developed" countries deal with.
I don't think there's more glaucoma. I believe we're seeing more glaucoma
just because we have better diagnostic methods than in the past. It's being
caught earlier and treatment is being started earlier to help prevent
blindness from it.
I don't think anyone is saying that stress causes glaucoma. The discussion
is related to whether or not stress increases the IOP, which may or may not
lead to optic nerve damage. Personally, I think the jury is out. Stress
does affect our whole body system and we should do our best to try to
relieve stress as much as we can.
Unfortunately, medicine today, esp in the US, is compartmentalized. A
person sees a general practitioner but that doc usually only views the body
from the medical point of view (there are others that look at all the issues
in one's life) and doesn't look at the social & emotional picture to
determine what could be going on. And a counselor will look only at the
mental & social issues and not the physical issues of a person. When you
start going to specialists, they're *very* narrow focused. I can't remember
the last time my ophth or glauc doc asked me how life was going for me.....
All they're looking at are my eyes.
Another problem is *time* for the docs. In many areas, they're overworked,
either because the group they're affiliated with requires that they see a
certain number of patients per day or because there's a shortage of docs or
specialists in the area. They need to focus and get right down to the
nitty-gritty of what's going on. It's a shame. I feel fortunate that my
docs have the time to talk wth me about what's going on!
Sherry

Stress is an integral part of life. Life happening is stressful No discussion here has changed my personal opinion that no one

knows what causes glaucoma or how many different causes there

actually are.

I hate when we get sidetracked into discussing whether stress can destroy the optic nerve.

If stress destroyed optic nerves, there would be many many more

blind people.

I believe that research dollars would be better spent on research dealing with the optic nerve damage.

I don't think that glaucoma has become much more widespread these past few decades than in the past and life is much more

stressful than ever, IMHO.

It isn't that I think that stress is ok for you. I think we all need to

relax more but you'll never get me thinking that my right eye is under much more stress than my left....

Glaucoma took the sight in my right eye and my left is ok so far.

So's my optic nerve. There are others here with one sided glaucoma. It is time to stop calling this disease glaucoma. It is

nerve damage caused by a very wide variety of causes. If the drug companies didn't finance the research and didn't make so much money off our drops, maybe there would be more research on what is actually going on here.

That's my rant for today.

Wish you all a peaceful day living and enjoying life with glaucoma.

It can be done. It's my goal.

love,

sari ;-)))))))))))))))))))))))))))

Sherry,
You mentioned TM as one of the things that might reduce stress and
therefore be of benefit in preventing elevated IOP. I have an interest
in hearing from any glaucoma patient who has tried TM.
If you have glaucoma or elevated IOP and you have tried TM (or any
formal Eastern meditation technique), please let me know what you
thought or think about it. Contact me here:
http://fiteyes.com/blogs/dave/contact.aspx
Regards,
Dave
http://fiteyes.com/blogs/dave/

Coming from an athletic background, I can say that it is well-known
that thirst is not a reliable indicator of fluid requirements
(especially for active people). In fact, my experience is that if I
only drink when I am thirsty, I do not get enough water. That's just
my experience.
You should also point out that it isn't drinking a lot of water that's
the problem (in regard to raising IOP) - it is drinking a lot of water
in a short period of time.
They say it is perfectly OK for a glaucoma patient to drink 8 glasses
of water a day if they sip the water throughout the day rather than
chug it.
Dave
http://fiteyes.com/blogs/dave/

Sherry,
When you say, "We've established the fact already that stress can raise
IOP. " Who is "we" and how was this fact established?
I'm asking because one of the main missions of my eye pressure blog
<http://fiteyes.com/blogs/
connection between stress and IOP so that serious scientists may become
interested in pursuing the connection and helping establish this as a
widely recognized fact. Most of us glaucoma patients have experiences
that give us great confidence that it is a fact that stress increases
IOP, but most medical doctors still seem to feel the connection has not
be proven.
I also want to comment on your statement where you said, "If a patient
has that much stress that he or she needs medication for the stress, he
should be seeing the appropriate specialist for counseling to help with
the stress rather than be fed more drugs!"
I am personally convinced that the connection between stress and IOP is
one of the most important neglected issues in glaucoma management. I
would even go so far as to say that many glaucoma patients (POAG) could
benefit greatly by addressing stress related issues. Most glaucoma
specialists neglect this, but the ophthalmologist in Thailand is simply
saying that he has noted some clinical benefit in his patients from from
intervention that helps manage stress.
I think his statement deserves attention rather than dismissal. He
doesn't appear to be a research scientist, but if he has good patient
records related to his treatments, his success with Xanax could be
exactly the type of thing that leads to new research.
In general, the medical profession will often attack and discredit the
messenger rather than focus on what might have value in the message. If
Xanax does indeed reliably lower IOP, that is a fact that deserves to be
known. (It is a separate question whether individual glaucoma patients
should be prescribed Xanax.)
I'm going to encourage the ophthalmologist from Thailand to elaborate on
his message on my blog and hopefully we'll find out more facts related
to what he has observed in his patients.
Regards,
David
http://fiteyes.com/blogs/dave/

Joyce,
I have had discussion awhile back with the "doctor" who posted this comment.
I do not trust the "credentials" he reports to have. He told me that does
not have any glaucoma training "only self study".
Regarding massage, which this "doctor" touts, Dr. Ritch wrote in Message
#11781
"We had patients massaging for years. Then we found out that the pressure
often comes back up an hour later. Meantime, massage makes the IOP go way
up, and possibly damages retinal ganglion cells while doing so. Thus, about
5 years ago, I stopped almost completely."
We've established the fact already that stress can raise IOP. There are a
lot of things that can cause an elevation of IOP at the time you have it
measured including the "white coat syndrome", holding your breath, wearing a
tight necktie or collar, etc. The measurement can even be affected with how
the technician or doc is holding your eye open!
I totally disagree with him recommending Xanax - he's an ophthalmologist,
for goodness sakes! Would you want to have a family doctor prescribe your
glaucoma drops? If a patient has that much stress that he or she needs
medication for the stress, he should be seeing the appropriate specialist
for counseling to help with the stress rather than be fed more drugs!
This guy also believes that myopia can be prevented, which I find very
questionable.
Sherry

The comment at the end:
http://fiteyes.com/blogs/dave/2007/02/25/Does-Stress-Increase-Eye-Pressure-For-E\
veryone

Lilian,
You'd have to know the stone analysis to find the cause and you won't get
that until you pass a stone and it goes through pathology.
Water, water, water - keep well hydrated to prevent stones.
http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/index.htm - there's
a long list of things that could possibly cause kidney stones and the only
medications listed (other than excessive calcium and vitamin C) are the
diuretics because they can dehydrate you and calcium-based antacids.
I doubt your IOP meds are contributing to the stones.
So sorry to hear that you were hit! Glad you're doing better now.
Sherry

Hi Sherry, Virtual friends, and hopefully Dr. Ritch,

Questions:

1- I now have small kidney stones (no symptoms, found in a scan), have been using Azopt and Lumigan for many years. Is there a specific way to test blood or urine to see if the Carbonic Anhydrase Inhibitor in Azopt (3x/day) may be contributing or triggering the kidney stones? Yes, I always do punctal oclusion.

2- I also use Lumigan 1/night. Is there a substitute for Azopt w/out the Carbonic anydrase inhibitor which could be tried if necessary? My eyes have been stable, and I hope not to need surgery any time soon. I have had iridotomy, irridoplasty, and SLT.

Although I have been on this list for years, diagnosed NAG 1998, I took some time out b/c I had to deal w/other issues which I can explain later (I was hit by a car when as a pedestrian crossing street). Am doing well w/that now although I was at risk for amputation of leg, am walking, treadmill, etc. and doing well w/limitations.

Thank you so much.

Lilian Rosenbaum

Well my Valentine's Day turned out better than expected. The
opthomologist said that I do not have Glaucoma, however I am Glaucoma
Suspect. The Xalatan had brought my pressure down four points in both
eyes, from 28 and 29. He said that still wasn't enough so he wants me
to continue using the Xalatan in my right eye every night and then use
Betimol in my left eye every morning and every night to see which one
brings the pressure down the most. If neither one of these works then
he said we need to consider laser surgery (can't remember the name of
it).
My next appointment is March 8th. So here's hoping.
Regards,
Sue/TN

i was on Timolol for a few years and my pressures were around 18-22. My doc seemed to think that was normal for me until the Timolol stopped working and pressures went up to 30. My new doc wants me under 20, so I'm now on Cosopt.

Dora
millerdavid2002 <millerdavid2002@...

Hi everybody!
I joined the group soon after a diagnosis of high eye pressure.
Possible glaucoma. At the time my eye pressure was 24 in the right and
22 in the left. After a month of Timolol eye drops in both eyes - one
drop in the morning and one in the evening - I went for a check up.
The pressure has dropped to 20 in the right and 18 in the left. The
doc said lets wait two more months and see if it drops further, or he
would have to consider other drops. He would like to lower the
pressure further and I understand that. I would just like to know from
others in the group what was the extent of pressure reduction after
the use of Timolol for a month. Was it significant or just a few
points like mine? Thanks.

When I walked in to my ophthalmologist's office the first time, my IOP was 48 in my right eye. The doctor put a drop of 0.5% timolol (gel forming solution) in my eye, and by the time I left his office less than 1 hour later my IOP was 22. (He also put 1 drop of Xalatan in my eye, but Xalatan takes about 5-6 hours before it even begins to lower my IOP, so it probably wasn't a factor in the reduction from 48 to 22.)

Your story reminds me of my own. You might find this blog article of interest: http://fiteyes.com/blogs/dave/2006/06/13/i-am-full-of-questions-now.

I spent the first two years after my diagnosis thinking that eye pressure changes from 20 to 18, for example, were significant and, like lots of other glaucoma patients, I based major decisions on the pressure readings taken every few months. However, once I started monitoring my IOP throughout the whole day I realized that my eye pressure covers a range of at least 7-8 mm Hg in just one day. Once I saw that, I read the research and realized that everyone's eye pressure goes through a range of several mmHg every day. Big decisions like drugs or surgery require better eye pressure data than one reading every month or so, in my opinion. Glaucoma should be managed like diabetes. A glaucoma patient should know how their eye pressure responds throughout the day.

That said, you aren't really a glaucoma patient, are you? It sounds like you may not have any nerve damage because you say "possibly glaucoma." On your next visit, why don't you ask your doctor about Xalatan? If you don't have glaucoma and the drops are just a preventative, maybe you should be on the safest drops at least it is probably asking about. Good luck.

Dave

http://fiteyes.com/blogs/dave/ - The Eye Pressure Blog

Hi everybody!
I joined the group soon after a diagnosis of high eye pressure.
Possible glaucoma. At the time my eye pressure was 24 in the right and
22 in the left. After a month of Timolol eye drops in both eyes - one
drop in the morning and one in the evening - I went for a check up.
The pressure has dropped to 20 in the right and 18 in the left. The
doc said lets wait two more months and see if it drops further, or he
would have to consider other drops. He would like to lower the
pressure further and I understand that. I would just like to know from
others in the group what was the extent of pressure reduction after
the use of Timolol for a month. Was it significant or just a few
points like mine? Thanks.

I agree that stress does adversely affect glaucoma. I've been a glucoma suspect for about four years, using no eye drops. After extreme stress in September, 2006, I went for my regular six month glaucoma checkup to hear that I now have nerve damage in one eye.
**************************************
AOL now offers free email to everyone. Find out more about what's free from AOL at http://www.aol.com.

Of course it makes sense that every persons IOP would increase in a stressful situation. How many people get migraines after a very stressful day at work ? How many doctors have said the words "stress kills" ?

As the ancient philosophers said ,
" A Healthy Mind Is A Healthy Body "

*

I always liked this one:

"Clean mind, clean body -- take your pick."

earle

*

Hi Chris, I am new to this group. Where is the meeting.

thanks

Indu
Christopher Saleh <chris.saleh@...

hi everyone ...
sorry for the late email
but i was just able to confirm
that our support group IS meeting tonight
at 6:30 PST ...
we DO have an awesome speaker ... Dr. Martin
Wax from Alcon Labs ... a world-reknowned
glaucoma specialist
see everyone tonight !!
thanks, chris

hi everyone ...
sorry for the late email
but i was just able to confirm
that our support group IS meeting tonight
at 6:30 PST ...
we DO have an awesome speaker ... Dr. Martin
Wax from Alcon Labs ... a world-reknowned
glaucoma specialist
see everyone tonight !!
thanks, chris

Sari, thanks a lot for your response. To me this came as a total surprise because for all practical purposes to me, my eye was fine. Visual field deterioration was not obvious to me and could be debated. And I was not forewarned that my eye will have this 'glaze' floating around that shifts my vision all the time. You are right that this must be dryness also. Because now my eye frequently turns red, itchy and hypersensitive to light. I did start using drops to relieve readness.I kinda feel that I moved too fast and that is why I am having hard time accepting vision loss. To me, this was an improvement surgery not a deterioration procedure. (just venting)

Anyway, there is no going back, so thanks to people like you, I am learning a lot from this group. Too bad that I did not join this group earlier. I depended on books and just online search which proved inadequate.

thanks and take care

Indu

sari <wsaber@...

I had a trabeculectomy last May. My eye looked like you described and I felt like you feel for quite a long time after the surgery.
Getting a second opinion is always a good idea.
I am now 9 months after surgery. My pressure is still low and my vision has slowly, oh so slowly, returned to almost what it was before the surgery. I was warned before the surgery that I would probably lose some vision as a side effect of the surgery. So it came as no surprise. We have the surgery to lower the pressure and hopefully, to retain as much vision as possible. Not having the surgery was not an option for me since I had lost so much vision in that eye. They were calling it terminal glaucoma in one eye. Hopefully I will retain what I currently have.
After I had the surgery, I had my eye (the one operated on) patched closed for awhile and I realized how valuable even the small amount of vision I have remaining in that eye.
The recovery was more difficult than even this pessimist expected but there is no going back. I've gotten used to the way it looks and I choose to believe that it was the right thing to do. I did my research. I got my second, third and fourth opinion and when I realized I had no choice, I agreed to have the surgery.
There is nothing I won't go through to maintain my vision.
The only discomfort I have today is a very dry eye. I try various things to improve the situation but most importantly, I enjoy seeing with both eyes.
Write whenever you have a question. We encourage participation and share our experiences freely. Glaucoma can be a real pain in the ..... eye.
love,
sari

Below is an opposing view, esp on Vitamin E. I believe the difference
is due to the form of vitamin E. It's the same issue with
beta-carotene. Many *isolated* nutrients are not safe. I have more
info on this if anyone wants it.
David
http://fiteyes.com/blogs/dave/
Vitamins E and C are safe across a broad range of intakes.
John N Hathcock, Angelo Azzi, Jeffrey Blumberg, Tammy Bray, Annette
Dickinson, Balz Frei, Ishwarlal Jialal, Carol S Johnston, Frank J
Kelly, Klaus Kraemer, Lester Packer, Sampath Parthasarathy, Helmut
Sies and Maret G Traber
1 From the Council for Responsible Nutrition, Washington, DC (JNH and
AD); the University of Bern, Bern, Switzerland (AA); Tufts University,
Boston, MA (JB); Oregon State University, Corvallis, OR (TB, BF, and
MGT); the University of California, Davis, Davis, CA (IJ); Arizona
State University, Mesa, AZ (CSJ); King's College, London, United
Kingdom (FJK); BASF, Ludwigshafen, Germany (KK); the University of
Southern California, Los Angeles, CA (LP); Louisiana State University,
Baton Rouge, LA (SP); and Heinrich Heine University, Dusseldorf,
Germany (HS).
A robust database shows that dietary supplements of vitamins E and C
are safe for the general population. Because these nutrients supply
antioxidant and other functions for homeostasis and protection against
free radical damage, supplementation has been intensively studied.
Because of perceived benefits, many persons consume quantities of
vitamins E and C well above the recommended dietary allowances. As
safety guidance, tolerable upper intake levels have been established
by the Food and Nutrition Board, Institute of Medicine, at 1000 mg for
vitamin E and 2000 mg for vitamin C in adults. Many clinical trials
with these vitamins have involved subjects with various diseases, and
no consistent pattern of adverse effects has occurred at any intake.
Numerous studies of vitamin C supplementation have provided no pattern
of evidence to support concerns about safety other than occasional
gastrointestinal upset or mild diarrhea resulting from the osmotic
effects of unabsorbed quantities of vitamin C. Evidence of bleeding
effects and other potential adverse effects of high vitamin E intakes
in humans is not convincing. Evidence of adverse effects of vitamin C
that result from its effects on iron absorption and metabolism has not
been confirmed in clinical trials. Thus, we conclude from clinical
trial evidence that vitamin E supplements appear safe for most adults
in amounts &#8804;1600 IU (1073 mg RRR-{alpha}-tocopherol or the molar
equivalent of its esters) and that vitamin C supplements of &#8804;2000 mg/d
are safe for most adults.

Bjelakovic G, Nikolova D, Gluud LL, et al. Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis. JAMA: The Journal of the American Medical Association 2007;297:842-57.
Abstract: Context Antioxidant supplements are used for prevention of several diseases. Objective To assess the effect of antioxidant supplements on mortality in randomized primary and secondary prevention trials. Data Sources and Trial Selection We searched electronic databases and bibliographies published by October 2005. All randomized trials involving adults comparing beta carotene, vitamin A, vitamin C (ascorbic acid), vitamin E, and selenium either singly or combined vs placebo or vs no intervention were included in our analysis. Randomization, blinding, and follow-up were considered markers of bias in the included trials. The effect of antioxidant supplements on all-cause mortality was analyzed with random-effects meta-analyses and reported as relative risk (RR) with 95% confidence intervals (CIs). Meta-regression was used to assess the effect of covariates across the trials. Data Extraction We included 68 randomized trials with 232 606 participants (385 publications).
Data Synthesis When all low- and high-bias risk trials of antioxidant supplements were pooled together there was no significant effect on mortality (RR, 1.02; 95% CI, 0.98-1.06). Multivariate meta-regression analyses showed that low-bias risk trials (RR, 1.16; 95% CI, 1.05-1.29) and selenium (RR, 0.998; 95% CI, 0.997-0.9995) were significantly associated with mortality. In 47 low-bias trials with 180 938 participants, the antioxidant supplements significantly increased mortality (RR, 1.05; 95% CI, 1.02-1.08). In low-bias risk trials, after exclusion of selenium trials, beta carotene (RR, 1.07; 95% CI, 1.02-1.11), vitamin A (RR, 1.16; 95% CI, 1.10-1.24), and vitamin E (RR, 1.04; 95% CI, 1.01-1.07), singly or combined, significantly increased mortality. Vitamin C and selenium had no significant effect on mortality. Conclusions Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further
study
------ End of Forwarded Message

Of course it makes sense that every persons IOP would increase in a stressful situation. How many people get migraines after a very stressful day at work ? How many doctors have said the words "stress kills" ?

As the ancient philosophers said ,

" A Healthy Mind Is A Healthy Body "

Another one I like is:

Any one who has common sense will remember that the bewilderments of the eyes are of two kinds, and arise from two causes, either from coming out of the light or from going into the light, which is true of the mind's eye, quite as much as of the bodily eye; and he who remembers this when he sees any one whose vision is perplexed and weak, will not be too ready to laugh; he will first ask whether that soul of man has come out of the brighter light, and is unable to see because unaccustomed to the dark, or having turned from darkness to the day is dazzled by excess of light. - ( Plato )

Dora Argy

[info]

My glaucoma specialist has disagreed with me on this, but my pressures were the
highest just before I left my ex, when my stress level was at its highest.
That's when I was put on drops after monitoring my pressures for years. (I have
pigment dispersion syndrome and became aware of that condition when I was 18,
kept under control for over 20 years.)
My pressures were high at my last appointment. This is the time of year when I
work 6 days a week, 10 - 12 hours a day, mainly on the computer or reading.
Everything I do has deadlines. It's all high stress.
I try to exercise daily or at least 5 times a week. That seems to help because
it reduces my stress level.
Elaine

Mel, I am a designer as well and the ability to discern shades of
color greatly concerns me too. At this point I only have optic nerve
damage in one eye, but I can definitely tell a difference in color
perception between the two eyes. While I wish the normal eye would
dominate in terms of color perception, they seem to average out so I
know I do not see color as well as I used to.
In general what is first affected in glaucoma is blue/yellow
sensitivity. With my bad eye, certain shades of olive will appear
greyish to me. This first became apparent to me when I was with my
husband helping him pick a tie to match a shirt, and he asked me why I
kept saying a tie was grey when it was a drab green.
I also have less contrast sensitivity in that eye, but I mainly only
notice it when coming from a bright room into a dark room. It doesn't
bother me too much because the other eye helps compensate.
I suppose I am fortunate because in my work, I'm aware of my
perception deficiency and can close one eye to compare. If both eyes
are affected, I think it would be hard to tell. I also think the
average person wouldn't notice the difference in color perception, but
someone like you or me does because shades of color are crucial in our
line of work.
-Deah

This topic came up in conversation again recently when I was meeting
with the product manager for a tonometer manufacturer. This person
measures eye pressure more frequently than most doctors. He surprised me
by saying that he sees a connection between stress and IOP in all
people, not just glaucoma patients. I wrote a blog article on the
details of that conversation here:
http://fiteyes.com/blogs/dave/2007/02/25/Does-Stress-Increase-Eye-Pressu\
re-For-Everyone

David, I don't know if its a common thing to receive a wide range of opinions
but sometimes when you aren't the norm doctors become a little wary and nervous
as to what to do. That's what I have experienced anyway. Most of their patients
are over 60 and are usually able to retain some sight until the day they die.
With patients much younger as in my case, treatment will be over a longer period
of time so doctors aren't too sure what to expect.
Initially I wasn't too worried because I was a glaucoma suspect but I knew
that something wasn't quite right. I mean pressures over 38 weren't exactly
normal. I did keep a positive attitude though and kept myself fit by exercising
at least three times a week and ate healthy. My doctors were always sceptical
but I told them that I knew when my pressures were up even before they were
measured. I would usually see halos around lights and when I would relax they
would disappear. At my fittest when I was jogging a few times a week my
pressures had dropped to 16.
My sister had severe multiple sclerosis and when I think or talk about her the
halos appear. At times I would walk into the gym seeing the halos and five
minutes into my workout they would disappear.
In 12 years I have hardly had any damage and that's with pressures that had
ben in the thirties. I was put on drops and the pressure did drop to around 22;
but I am a believer that stress increases IOP.
It's not a myth but a fact.
Surely my experiences and Davids can't be coincidence?
Dora

Hi,
I understand contrast sensitivity is a problem with glaucoma. I work
as a web designer, and am sure to make sure there is good contrast on
any sites or even in the graphics I design.
I have been told by clients the quality that sets my work apart is my
use of color. I have always been able to distinguish the most subtle
variations in shades of color. Is this something I will lose as a
result of glaucoma? I know being able to see anything is far more
important, but this could have a significant impact on my work.
Mel