lower limit for iop

[Macavity99]

I have normal pressure open angle glaucoma. On diagnosis pressures were around 16 if I remember correctly. Damage seems to continue, I’ve been put on drops, first latanoprost, did nothing, then bitamoprost, which has reduced to 11/12. I’ve just had a cataract done on L eye and the specsavers follow up gave it as 7 on the puff test. The eye hospital is being slow to get back with advice on whether to stop in that eye. Is it just pressure or does it do anything else? I’ve stopped for the moment.

I’ve not been given a target, or a minimum level. Nor any idea as to how many missed days matters. I do try hard to be compliant. It would help if there were practical information on things like this.

[KieranGlaucomaUK Administrator]

Hello.

It is recommended to use your drops as prescribed until told otherwise by your eye specialist.

This sounds like something worth discussing at your next appointment with your consultant. You can always give the eye secretary at the hospital a call as well, as they will be able to assist you further with this.

[KayGeeBee]

I too have normal tension open angle glaucoma. Drops would only get pressures down to the mid-teens, so I had preserflo surgery in both eyes, pressures at last check were 10 and 7 but they fluctuate a little of course. I don't think there's a numerical minimum pressure, it's more a matter of what each eye can tolerate. If you aren't having vision problems then 7 may be fine for you, but it is something to discuss with your specialist. I wouldn't change my medication based upon a single reading at the opticians.

[AlfredV]

Hypotony is the term for low IOP. At glaucoma.org/hypotony it describes hypotony as a pressure below 10, but also states that it isn't necessarilly a problem until it gets below 5, although I suspect the exact figure can vary from person to person.

This isn't medical advice and I don't think you have too much to worry about (worrying won't help), but it is worth discussing with your consultant at the next appointment.

I wonder whether you would benefit from a neuroprotective diet? I reduced my carbohydrate intake to a bare minimum, cut out all added sugars, grains, processed foods and vegetable seed oils and it seemed to improve my eye health and general health overall. Something to think about and look into.

[KayGeeBee in reply to AlfredV]

According to onlinelibrary.wiley.com/doi... there isn't a standard definition of hypotony.

[PBX142 in reply to AlfredV]

Can I ask why you cut out grains? All grains?? Thanks

[AlfredV in reply to PBX142]

Yes. I no longer eat wheat, barley, oats, rice, corn, rye, etc. They aren't particularly nutritious, contain many antinutrients and often are heavily treated with glyphosate and other pesticides/herbicides. They have a very high carbohydrate content and contain proteins that can promote inflammation. My only exception is beer, and to be honest I should probably cut that out but the fermentation changes the nature of the grains somewhat.

[PBX142 in reply to AlfredV]

Wow, interesting….Do you not get hungry without carbs? I’d love to manage without and have been influenced by a book called Wheat Belly (no explanation needed!)

[AlfredV in reply to PBX142]

It was Dr Davis that first got me onto it over 3 years ago now (his other book, Undoctored). I used to be hungry all the time but now only eat twice per day, and rarely get hungry. As a plus, a few months after starting this way of living, my eye pressures dropped by around 25% and remained that way, which was very welcome news. I don't know the mechanism behind why this happened but have heard similar anecdotes from others.

[PBX142 in reply to AlfredV]

Your experience is very encouraging...both for one's general health and for eye pressures. Thank you. I'll take a look at Dr Davis and Undoctored too.

[Beecalmed]

Hi!

The puff test for IOP that the opticians use is not the most reliable indicator when it comes to fine margins of IOP particularly seen in normal tension glaucoma. You need the hospital to do the one that touches the eye.

We all have different IOP levels that are healthy for us. We don’t all fit into the average range. Yes do ask your consultant what your healthy/safe range is.

Normal tension glaucoma possibly has other things at play causing damage than just IOP level. The researchers are still working on discovering what that is.

[Macavity99]

hi all

Many thanks for such prompt responses. I’m still waiting for hospital to get back. I’ll be chasing, also to get a follow up, the review process isn’t very systematic, they are obviously under a lot of pressure. I’m not unduly worried.

The optician said the puff test tends to read high compared to the hospital gadget. Also, I’ve read there is quite a variation during the day. One test certainly is very limited. I’d like to be able to monitor the iops at regular intervals, and would happily pay, but it doesn’t seem to be available

I was told about the BP “dipping “ at night theory early on, and was told bluntly I was on a tightrope between going blind and having a heart attack. ( from AF and high BP) . This was dismissed by a different consultant. As there is an established association between AF and glaucoma, it seems to me very likely that blood supply is at least part of the story. I put this to the AF association that i also belong to, but their medics weren’t very interested.

[PBX142 in reply to Macavity99]

Re monitoring IOP yourself: SpecSavers and the high street opticians aren't interested in doing that but you might be able to make a regular arrangement with a local independent optician for a fee.