IOP and glaucoma progression

[kika9]

Hi everyone 👋, i keep reading on this forum on facebook how people have IOP around 10 to 14. Whenever I get my IOP measured it varies between 20 to 21 so I am getting worried a lot. Also I read on the internet that with IOP 21 in 15 years my glaucoma may progress, which is worrysome because I'm 23 so in 15 years I will be just 38 so... One thing is I hate getting my IOP measured I don't know why but it happens eversince I was little, I just hate that air blowing into my eyes, could this stress effect that my IOP is little bit higher?

P.S. sorry for ma language I am not a native english speaker 😊

[Toby_from_London]

Hi Kika,

Eye pressure can vary from person to person; what is deemed as a high IOP for some may not be an cause of concern for others.

However if you have any concerns it may be best to visit an eye specialist who can give you an accurate reading using precision equipment as well as a full examination, as glaucoma is not necessarily caused by high IOP alone. This may put your mind at rest; where do you currently get your eye pressure checked?

I understand this is a stressful time but please try not to worry as that may in itself raise your IOP, but I know that's easier said than done🙂

Take care.

[kika9 in reply to Toby_from_London]

Hi Toby, thank you for your kind response.

I am trying to think positively but once I start thinking too much the positive thinking is pretty much over Anyways, I am getting my IOP checked every 3 months at my oftalphomologist and twice a year at my glaucoma specialist. However, I do have som doubts about my glaucoma specialist, because where I live our health care is having some issues so I am really not sure if my GS is reliable :/

[Trish_GlaucomaUK Partner]

Hello kika9,

As Toby_from-London mentioned, IOP's vary from one person to the next.

Everyone's eyes are different, with no two people the same.

Someone can have a pressure of 15mmHg for example, with signs of progression, whereas another person can have the same IOP and their glaucoma is stable with no progression.

The range of pressure is between 10mmHg and 21mmHg.So you are in the higher range but not over.

You do not mention that you have glaucoma, or are a glaucoma suspect or whether it is ocular hypertension, which is when the IOP is high but no sign of glaucoma.

Either way, your consultant will be trying to reduce your IOP to a more stable level, which in turn will reduce the risk of either more progression, or the development of glaucoma. This will be with eye drops or possibly laser. They sometimes prescribe eye drops as a preventative to stop glaucoma from developing, but not always. The same with laser.

If you have not been prescribed or treated, this could be that you are either Ocular Hypertensive or a Glaucoma Suspect, where you will be monitored closely. If signs of glaucoma start to show, treatment will start.

IOP's fluctuate throughout the day. The stress of having you IOP checked with a puffer test should not effect it to a point of concern, if at all.

[kika9]

Hi Trish,thanks for your explanation I am officialy diagnosed with glaucoma, that is why I am getting a little bit stressed out about this. And as I mentioned I am having some concerns about my glaucoma specialist so that is why I am looking for some advice online.

But from now on I will definitely keep in mind that IOP's vary from one person to another

[Jon1988]

I’m 34 and also have glaucoma in my left my, right eye is suspect. The only way to truly gain an insight into your IOP is by purchasing a tononmeter and measuring it home, they are expensive but it’s a game changer. I was monitoring my IOP for 3 months and it was always below 15 during the day, get it measured at the hospital, 17. More than likely stress and I was able to discard the reading. What medication are you on? Also do you often get measured at the same time of day? My IOP rises around 9am until after lunch time then drops a few points for the rest of the evening. I was able to add another drop due to this which has countered it nicely, something I wouldn’t have known without the tonometer.

[frankthebank in reply to Jon1988]

Hi Jon, I concur with what you are saying here, the IOPs are so variable, I have Secondary Glaucoma in just one eye, but everytime I go to the hospital they check the other eye ( I have been a lot this year ) I noticed though that in the eye with no Glaucoma the IOP can vary anywhere between 11 and 19; Its literally different day to day, so I think it's important to realise that it's natural for this to fluctuate. I just wanted to ask though which tonometer did you get? as I'm looking at getting one as well. TBH I'm starting to think that this is an essential bit of kit we should all have at home. Thanks

[Jon1988 in reply to frankthebank]

Hey Frank, I have the Icare home 2, it’s a pretty significant investment but I would buy it again if anything happened to mine, it really empowers you to take control over your IOP. When I first got it I did an experiment with my consultant, he took a measurement using his Goldman device, and I used the Icare and they matched up perfectly, so my consultant has complete faith it now. It’s interesting as well because my consultant was thinking about buying one to rent out, and I think my data pushed him closer which will bring benefit to all his patients. If you do get one I would be interested to hear about your night time IOP, it’s often high for everyone, more so for us glaucoma folk, I noticed mine was going as high as 24 every night and I’ve managed to mitigate it now and it rarely goes above 17 now. Once I shown my consultant the data from these spikes he quickly added two drops on top of latanoprost that I was taking. I was able to reduce the spikes with sleeping position, and I’ve since managed to remove a drop, so down to two, which wouldn’t have been possible without the tonometer, in fact I probably would have had surgery because that’s what he was talking about if I progressed.

[frankthebank in reply to Jon1988]

Thanks for your reply Jon, I'm going to look into that, it's expensive but if it comes to saving eyesight, definitely worth the investment. When I get one I will keep you posted how I get on with it. Kind regards

[tkhach44 in reply to Jon1988]

I need a tonometer too, as I prefer having my own. I would appreciate to know where I can buy it.

[Jon1988 in reply to tkhach44]

I bought mine from here: main-line.co.uk/products/ic...

They are made in Finland and took about 3 weeks to get to me from order, process was straight forward. Also the tonometer is easy to use.

[Jeffvader in reply to Jon1988]

Hi Jon,

How quickly did it take you to learn how to use it? Is is that simple or did you poke yourself in the eye a few times before you got the settings right? 😂

Seems like a great bit of kit, expensive but great. My worry would be actually having the confidence that I am using it correctly

[Jon1988 in reply to Jeffvader]

The hardest bit is setting the application up, but it’s not hard so don’t be put off. You just need to create an account, and connect your phone to the tonometer using Bluetooth, there are guides though and it took me about 5 minutes. It’s extremely straight forward to use, and there is a YouTube video that shows you as well. You just turn it on, put a probe in which gently touches your eye, the hospital use them so you have likely had this, then hold the button. It takes 6 measurements, discards the lowest and highest, and gives you the average of the remaining 4. It then shows the IOP on the side. You can also sync it with the application and periodically upload your data which you can then perform some analysis on, the software gives you breakdowns and shows trends, and how your IOP fluctuates over the day. That’s how I noticed I needed another drop, because my pressure was rising around 9am until after lunch time.

Also you can’t really poke yourself in the eye, when you have inserted a probe it won’t attempt to take a reading, I.e the probe won’t move until it’s lined up with your eye, it has a light that changes colour when it’s in the correct position, so you can’t really mess it up, it’s a very well built bit of kit.

[Jeffvader in reply to Jon1988]

Hi Jon, thanks for the reply and the indepth response appreciate that. It sounds like a good bit of kit. A more reassured about the poking in the eye situation now ☺️ I am always concerned about pressures between visits to the doctors, I had agreed to see my optician more but that's obviously not as convenient. One more question if you don't mind. Did you buy the probes in the UK? I see they are only single use, so imagine you need to keep buying more frequently? Or are they sourced from the same place as the machine?

[Jon1988 in reply to Jeffvader]

Hi Jeff, no worries. You can buy the probes from the same vendor as the tonometer, tbh I just clean them and reuse them, and I know many other that do the same. I just use tweezers to remove the probe and leave them in contact lenses solution for a few hours. Other people dip the probe in alcohol but I figured contact lense solution is designed for cleaning and reuse so it should be fine and has been so far.

[Stringwells]

The up to date equipment for measuring IOP does not blow puffs in the eyes any more. You could find another optician and ask them. The hospitals should too. Tell them your concerns.

[PBX142]

I agree with Stringwells. If you are being monitored for glaucoma then you should be having measurements with an accurate tonometer. The air puffer often measures higher and just isn't accurate at all. I don't think at this stage you should be buying a tonometer - they cost thousands anyway - but you should be having proper assessments with up to date equipment.

[LowpressureG]

Kika, it’s possible you’re getting a skewed view of IOP from that Facebook group you belong to. The one I’m familiar with is called “Glaucoma Support for People with Normal/Low Tension Glaucoma” and it’s specifically for people with lower IOPs.

[kika9 in reply to LowpressureG]

Hi, this one that I am in is just called glaucoma support group

[kika9]

Thank you all for your responses ♥ I really appreciate it. I will make sure to work up the courage and ask my specialist about the measurements of IOP