Difficulty in taking my IOP
1
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5 weeks ago
holt • 10
@Holt

I am 58, in very good health and I have been monitored for glaucoma ever since 2013 when my IOP was measured as high as 24-25 although it was usually around 21/22. All other tests such as VF and OCT, as well examination with ophthalmoscope, have had good results (except recently an OCT which I have reason to believe had false results due to operator error - see other post).

It's always been hard for the tech to take my IOP because I have long eyelashes. They have always had me widen my eyes as much as I could and then ask for a bit wider. Sometimes I was given an alternative such as having my eyelashes wrapped in a cue tip which I didn't want to allow.

In 2018, the tech initially measure my eyes at 25 and 26, with me having to hold my eyes open as wide as possible because she kept saying my eyelashes were in the way. I said to her that seemed high and could she try a different way where I didn't have to hold my eyes so wide. She did it again, except this time held my eyelid up gently with a finger, one at a time. This time the measurements were 19 and 20. I told the doctor what happened and he kind of brushed it aside and said yeah, IOPs fluctuate. After the appointment with VF, OCT etc. all good as usual, I decided to not come the next year. After all 19-20, even 21-22 are in the "normal range" of 12-22 mmHg (per glaucoma.org).

In 2020, 2 years later, when I came for the appointment, I asked the tech if she could please hold my eyelids up because of my long eyelashes and was surprised when she said she wouldn't, that she would do it her own way. She seemed a bit defensive about it unfortunately. It put me on edge a little also. When it came time to do the IOP, she seemed to change her mind (not sure what her way was, maybe trying to thread it through my eyelashes) and did actually try and hold my eyelids up, I wasn't sure. The pressures came out R19, L25. Later when the doctor saw me I asked him to measure the IOP, explaining the challenges with my eyelashes. He held apart my eye area with a hand while doing it. He got R21, L22. He shook his head and admitted that it was difficult indeed to take my pressures. He said with my eyelashes, there's definitely going to be some measurement variability. I asked about alternative ways to measure IOP, let's try one of those, and he said no, the way they do it is the gold standard.

I will be seeing him soon in November 2021 at which point my IOP will be measured. I have learned a lot recently from FitEyes that I didn't know before. For example, that "whitecoat syndrome" can happen with IOP measurements not just regular BP. I have definitely had this in the past. I seem to have the physiology that although I can handle a lot of stress, even when I feel just a little on edge, my BP goes up. So I think there's a good chance there's an element of that at play too, especially with the history of difficulties in getting the IOP measured.

I would like to get to the bottom of whether I am really at risk for glaucoma, as in the past the doctor has told me the sole reason for the yearly testing is higher IOPs. I would like to be able to verify whether white coat syndrome is at play, which I would think I could do if I had a tonometer that even though it may not be as accurate as the in-office one in an absolute sense, is accurate enough in a relative sense.

I don't want to invest thousands of dollars to buy a tonometer at this point, but I wonder whether it makes sense to rent one, say the iCare Home. But then my concern would be how would I be able to use it on myself with my eyelashes when the techs struggle with that even in the office? Are there other tonometer alternatives/technologies that would be easier, even if they weren't as accurate?

Would appreciate any comments/suggestions! Doug

iop:intraocular-pressure • 84 views
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5 weeks ago
david 3.2k
@david_fe

I would like to get to the bottom of whether I am really at risk for glaucoma, as in the past the doctor has told me the sole reason for the yearly testing is higher IOPs. I would like to be able to verify whether white coat syndrome is at play, which I would think I could do if I had a tonometer.

Yes, indeed. From my experience having a tonometer at home is the only reliable way to get to the bottom of this.

that even though it may not be as accurate as the in-office one in an absolute sense, is accurate enough in a relative sense.

If you read the posts here, you will see that at-home IOP measurements can be more accurate (in an absolute sense) than in-office measurements. In your case, that may be even more true.

I wonder whether it makes sense to rent one, say the iCare Home.

Yes, that seems like a good option for you. Please contact Enlivened. See:

Tonometers - Enlivened Tonometer Rentals

But then my concern would be how would I be able to use it on myself with my eyelashes when the techs struggle with that even in the office? Are there other tonometer alternatives/technologies that would be easier, even if they weren't as accurate?

I believe the Icare will work fine for you, even with long lashes. The Icare does require a lot of practice, however. Your lashes may involve you being a little extra diligent in your practice and use of the tonometer, but I think the rebound technology of the Icare may be the best tonometer technology for you.

My eye lashes can get in the way with other tonometers sometimes, but I don't have any issue with an Icare. Your mileage may vary of course.

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5 weeks ago
Mary Beth • 300
@beth

One drop grew my eyelashes very long too. They used to brush the inside of my glasses, so I took to trimming them ever so slightly. It’s just hair! I was careful to use the back and center of the scissors, keeping the ends way past my nose for safety. They did grow much slower than hair on my head, so it was not very frequent that I’d have to do this.

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5 weeks ago
david 3.2k
@david_fe

Dr. Robert Ritch has a suggestion for you. He says:

Consider trimming your lashes.

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