Re: Different approach 2 eye doctors...

Interesting. Of course, IOP is often the first indication of risk, and
also the single variable that is treated. In the absence of any other
finding, a pressure of 28 will not necessarily result in treatment.
The findings of the Ocular Hypertension Study do suggest that benefits
of treatment outweigh the risks at elevated pressures. However,
elevated pressure may be the result of a thicker than average cornea.
LASIK results in a thinner cornea, hence the IOP must be adjusted
following LASIK, depending on how much tissue is removed. Figure about
20% reduction. This reduction can obviously confound the diagnosis.
Also, there is considerable pressure exerted on the optic nerve during
the use of the suction ring. I think this bothers some glaucoma
specialists who are, after all, trying to save nerve tissue.

Anyhow, back to pressure. No matter what the pressure, if there is
another positive finding, such as abnormal cupping, abnormally thin
nerve fiber, abnormal visual field, then the diagnosis of glaucoma can
be legitimately made.

Also, of the various methods used to measure pressure, the standard
seems to be Goldmann applanation or some other applanation technique
such as the Tonopen.

I am leaning towards the first diagnosis. Perhaps you should go for
two out of three.

DrG

.

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