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  • question about test for IOP, kind of freaking out

    I've been on and off Alrex over the last five years, probably a few weeks at a time maybe on 4 occasions for an irritated pingeucula (dry eye makes it get inflamed). So not for 5 years straight!

    I'm now back on it for a little bit, 1 drop a day for terrible allergies that I cannot seem to manage with antihistamines, etc. I tried restasis and had a terrible reaction and I"m afraid it's just not for me. I'm of course worried about IOP, and my eye doctor said that he is not concerned because he'll be monitoring my IOP, and I have not shown signs of being a steroid responder in the past.

    Well, I got to googling how he checks my pressure. I have NEVER remembered anything touching my eyes, or a "puff" of air, or anything like that. The only thing I recall him doing in my exams is putting a drop of yellow dye and then using the blue light in the slit lamp.

    I'm panicking now that he hasn't actually checked my pressure! He's a very well known eye surgeon at the hospital, is a cataract/glaucoma specialist, etc. and I trust him - but now I'm worried!

    Are there ways to have your pressure checked without him touching my eyes? Because like I said, all is remember is the yellow dye and blue light (in addition to other stuff like regular slit lamp lights, and vision tests, etc). He's never told me what my numbers are or anything like that, just said nothing is elevated or anything like that.
    Last edited by Nanerpus; 10-Jan-2011, 17:40.

  • #2
    Hi Nanerpus, I never used to know when my ophthalmologist was checking the pressure in my eyes. I can't feel it touch my eye and am staring through the testing instrument so can't see what is going on. A new ophthalmologist told me when he was checking the pressure but I never could feel a thing. I only know now because the assistant takes the pressure with a portable instrument. Still can't feel it but now I can see what is going on. Hope this eases your worries.
    Lynda

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    • #3
      Originally posted by magoo View Post
      Hi Nanerpus, I never used to know when my ophthalmologist was checking the pressure in my eyes. I can't feel it touch my eye and am staring through the testing instrument so can't see what is going on. A new ophthalmologist told me when he was checking the pressure but I never could feel a thing. I only know now because the assistant takes the pressure with a portable instrument. Still can't feel it but now I can see what is going on. Hope this eases your worries.
      Lynda
      Phew. I do feel better. I know I asked him once about how he checks it and his reply was, "With the blue light" which I do remember him several times over the years, with yellow dye in my eye. I'll ask him more specifically next time, but I think I need to stop worrying and trust him, as he has never steered me wrong all these years. Thank you very much for your reply Lynda!!!

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      • #4
        The yellow dye is actually an anesthetic drop which numbs your eye so you won't feel the instrument touching it. The blue light is is the tonometer measuring the IOP. Be thankful your doctor is checking it.
        Every day with DES is like a box of chocolates...You never know what you're going to get.

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        • #5
          Originally posted by kitty View Post
          The yellow dye is actually an anesthetic drop which numbs your eye so you won't feel the instrument touching it. The blue light is is the tonometer measuring the IOP. Be thankful your doctor is checking it.
          I sense a tone about the steroid drops, or maybe I'm just being sensitive and paranoid. I don't mean that in a snippy way so please don't take it like that. More, I invite your thoughts. I am very worried about being on them, after reading the horror stories. I constantly am wondering if it is the wrong choice. I've tried Restasis, I'm on pataday and it's not doing anything, I'm using PF tears all the time to wash away the allergens, done all the elimination I can, am on both natural and drug antihistamines (Allegra).

          My doctor says the inflammation is superficial and not dangerous, so maybe I need to just deal with it until I grow out of my allergies, instead of the steroids. Kitty, please let me know your thoughts. I am desperate to do the right thing for my eyes, and while I trust my doctor, I am a cautious person by nature and don't want to end up with glaucoma because I'm embarrased about the redness.

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          • #6
            And the yellow dye also fluoresces under the blue light so that the technician can see the surface of the cornea (and not go too far in with the sensor).

            They tell you to hold your eyes wide open, and then there's this little tiny "plunger" shaped thing that they move toward the eye and then just touch the surface lightly to get the pressure reading.

            Usually, it's the techs that do the measuring. I've hardly ever had an eye appointment without the glaucoma pressure being checked---it's routine.

            C

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            • #7
              Originally posted by Nanerpus View Post
              Kitty, please let me know your thoughts. I am desperate to do the right thing for my eyes, and while I trust my doctor, I am a cautious person by nature and don't want to end up with glaucoma because I'm embarrased about the redness.
              Concerns well noted. I share them. I have been on Lotemax twice daily for nearly two years now. For the first year my IOP was not monitored. The Lotemax was prescribed by a dry eye specialist. I went back to my usual eye doc for an annual exam and he noted my IOP had increased significantly, not to the point of glaucoma but to a level worth watching. He is now giving me my prescriptions for Lotemax with very close monitoring. I have IOP checks and a retinal scan every 3 months. From what I have read, steroid induced Glaucoma will resolve on its own once the steroids are discontinued, and as long as no damage has occurred. The other issue is the development of cataracts from the steroids. I have an early cataract, had it long before I started the Lotemax. It does not seem to be maturing very quickly so I am not concerned about the steroid use from that perspective.

              What I am saying is, each person needs to make their own choice about how to treat their DES, based on being educated about the risks and benefits of the proposed treatment plan. I am well aware of the risks, and am comfortable with the regimen I am on as it is the only thing that brings me some relief. I understand I will need to discontinue Lotemax the second my IOP increases to a level above 22. I must also say that my eye doc is not certain it is the Lotemax that is causing this IOP increase. The only way to know for sure is to go off of it.
              Every day with DES is like a box of chocolates...You never know what you're going to get.

              Comment


              • #8
                Originally posted by kitty View Post
                Concerns well noted. I share them. I have been on Lotemax twice daily for nearly two years now. For the first year my IOP was not monitored. The Lotemax was prescribed by a dry eye specialist. I went back to my usual eye doc for an annual exam and he noted my IOP had increased significantly, not to the point of glaucoma but to a level worth watching. He is now giving me my prescriptions for Lotemax with very close monitoring. I have IOP checks and a retinal scan every 3 months. From what I have read, steroid induced Glaucoma will resolve on its own once the steroids are discontinued, and as long as no damage has occurred. The other issue is the development of cataracts from the steroids. I have an early cataract, had it long before I started the Lotemax. It does not seem to be maturing very quickly so I am not concerned about the steroid use from that perspective.

                What I am saying is, each person needs to make their own choice about how to treat their DES, based on being educated about the risks and benefits of the proposed treatment plan. I am well aware of the risks, and am comfortable with the regimen I am on as it is the only thing that brings me some relief. I understand I will need to discontinue Lotemax the second my IOP increases to a level above 22. I must also say that my eye doc is not certain it is the Lotemax that is causing this IOP increase. The only way to know for sure is to go off of it.

                Thank you very much for sharing your experiences and knowledge about this. I've decided to give it a few weeks, which is the same time frame I've used before with the pingeucula inflammation, at the 1 drop a day of Alrex. It helps immensely with the itchiness and bloodshot eyes when I start to have an attack. I'm allergic to horses and was in a barn yesterday to do a massage, and the itch came back but then went away after.

                I don't know what my IOP number is, just that the Alrex has never in the past increased my pressure according to my doctor - he usually has me come in for a check at 1 week or 2 week intervals. When I see him next, I'm going to probably discontinue and see if I can deal with the allergies/DES other ways, saving the Alrex for when I am at my absolute worst.

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                • #9
                  Originally posted by calli66 View Post
                  And the yellow dye also fluoresces under the blue light so that the technician can see the surface of the cornea (and not go too far in with the sensor).

                  They tell you to hold your eyes wide open, and then there's this little tiny "plunger" shaped thing that they move toward the eye and then just touch the surface lightly to get the pressure reading.

                  Usually, it's the techs that do the measuring. I've hardly ever had an eye appointment without the glaucoma pressure being checked---it's routine.

                  C
                  Thanks for more details. I have only had a tech do this once, usually my eye doc puts in the yellow dye and uses the blue light, and I never realized anything touched my eye! I just thought he was checking my tear film or something. Feeling much better now. Thanks!!!

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                  • #10
                    I've had my IOP tested the same way (yellow dye, blue light). Don't worry, he is measuring it. If it makes you feel any better, I am a steriod responder (i.e., my IOP rises with steroids, even the safer ones) and I was on and off of them for about a year and I haven't had any problems. As long as your Dr is monitoring you, you should be fine. Trust me, I am as big of a worrier as you.

                    I am sorry you are having a tough time. I felt the same way--that I had tried everything and I was never going to get relief. I also thought that the chronic inflammation would start affecting my vision--especially since it looked so horrid. But my DR said that there are hundreds of drops/drugs to try and we just had to find the right combination for me. You just haven't found yours yet, but you will. I can tell by your posts that you're acting proactively with your condition, so you'll find the solution.

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                    • #11
                      Originally posted by Amy_NJ View Post
                      I've had my IOP tested the same way (yellow dye, blue light). Don't worry, he is measuring it. If it makes you feel any better, I am a steriod responder (i.e., my IOP rises with steroids, even the safer ones) and I was on and off of them for about a year and I haven't had any problems. As long as your Dr is monitoring you, you should be fine. Trust me, I am as big of a worrier as you.

                      I am sorry you are having a tough time. I felt the same way--that I had tried everything and I was never going to get relief. I also thought that the chronic inflammation would start affecting my vision--especially since it looked so horrid. But my DR said that there are hundreds of drops/drugs to try and we just had to find the right combination for me. You just haven't found yours yet, but you will. I can tell by your posts that you're acting proactively with your condition, so you'll find the solution.

                      Thanks for telling me all that! It definitely helps. The 1 drop of Alrex daily is doing wonders for me, it's truly amazing...but I know I can't do it indefinitely. But maybe a short course can help me get the inflammation under control and get things moving in the right direction. I feel much better learning about the IOP and realizing that he is monitoring me.

                      I don't know if we are dealing with the same inflammation, but my doctor told me that what we are dealing with and have been dealing with is all superficial inflammation - he said is was cosmetic and although it looks bad it's nothing below the surface and won't do any damage. It's allergies and that sort of stuff. I don't know if that makes you feel better too?

                      But I know what you mean - when it looks horrible and feels itchy and stingy and uncomfortable, it's hard to believe it's not damaging anything. He said the goal is to manage the allergies and help me get on with my life, but that the steroid would also probably help the dryness as well, by letting the inflammation decrease.

                      Yesterday and today were the best days I have had in months. I don't know for sure if it's the drop of Alrex, or Allegra kicking in, but when I woke up this morning my eyes were crystal clear white and no insane itching and stinging!!!!


                      I'm rambling now. Thank you so much for your support and have a great day!!!!

                      Comment


                      • #12
                        Yes, same type of inflammation--superficial. Alrex wasn't strong enough for me--I had to use Tobradex which is much stronger and very dangerous. So, the fact that you are responding so well to Alrex is a positive sign. Enjoy those good days.

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