Tonometer

My daughter (see, there I go again, starting a blog post with those first two words) has an eye pressure issue.   To be more specific, one of the issues with her eyes is the pressure.  Initially, after the infection or inciting cause of her vision loss, she had trouble maintaining pressure.   It was at zero for a long time and then had to be maintained by an artificial fluid, Healon, that was added into her eyes.

The thought was that her ciliary bodies that produced ocular fluid would never recover, but of all the things that have gone downhill in her eyes, this one area has regained some function.   Her eyes now seem to be maintain pressure without a problem.   Or without a low pressure problem.

The next problem (in the realm of pressure, because we have lots of problems with her eyes) was high pressure.   And this was unexpected.   High pressure we never thought we’d have.   But high pressure isn’t a good thing either as it can cause glaucoma.   The probable cause for the high pressure is the total amount of debris in my daughter’s eyes.   The debris slows the drainage of fluids.   The good news is there are drops to help—and my daughter is an expert at drops.

We’ve talked to my daughter’s doctors about getting a handheld pressure reading machine at home.   I had the idea after seeing these nifty little machines my daughter was abjectly afraid of that did a painless in-office check of her pressure.   Could we get one?   I would buy one if it would be helpful, I asked.  And yes, just like all specialized medical equipment, it was expensive.   But so is flying a child and parent to Detroit to find out what’s causing vision loss or erratic vision, so I though what the heck, at least it was an idea.

We’d been told it was hard to get reliable readings because many factors affected pressure.   And I was fine with that, but I wasn’t talking about taking her pressure just once and panicking if the reading was particularly high or low.   I was thinking with regular readings we would get an idea of what her pressure was trending towards.

But since her doctors didn’t think it was a good idea, I didn’t press it.   But I didn’t forget about the idea either, bringing it back up from time to time.  At our most recent visit to Detroit I mentioned it again to Dr. Trese about getting a monitor at home again.   He told me at Duke, one of his peers was running a trial for at home monitoring and I should ask if we could get her into the study.   He’d talk to Dr. Grace about it as well.

And that was all it took.   Earlier this week we went to see Dr. Grace and we now have an iCare rebound tonometer.



If you’ve ever had your pressure taken at the optometrist’s office, this is like the machine they might use.   Historically they used a puff of air in your eye, but the newer, tonometer technology has been around for a while now.   If you’ve had this done to you, you might have heard nothing will touch your eye.   You might also have been given numbing drops before your eye doctor came in to see you.   The not touching your eye part is a fib—it does.   But it’s fast and it certainly doesn’t hurt.

See the little doodle bobber sticking out of the one post (the one on the left is to rest on your forehead for stabilization)?  That thing bounces out and taps on your eye.   That little piece is disposable.  It’s housed on a tiny, thin piece of metal that magnetically sticks inside the main housing of the unit.   Tip the unit over and it falls right out.   But held upright, if you press the button it bounces out and depending on the resistance it gets when it touches your eye, it determines a pressure.

To get an accurate reading it needs to do this five times.   My son and I have tried it and we didn’t have numbing drops.   You can really barely tell it’s there.

What we’re doing is recording the data from my daughter’s readings, done twice per day, into a spreadsheet so we can get data over time.   There is also a web site we enter the data into so the study coordinator at Duke can follow along and make recommendations in changes in medication as necessary.   Just from the first try at the office earlier this week, we adjusted my daughter’s drops in her left eye, which was high again.

My daughter isn’t particularly happy she has another eye thing to do every day, but since it’s just been Halloween, we’re bribing her with candy for now until it becomes part of her normal, daily routing.   I’m very happy we were able to get into the study.   This is just what we were hoping to do at home but without having to buy our own reader.    And we wouldn’t have been able to get a cheetah patterned one to be sure.

The Big Boy Update:  My son wanted a new bike.  One with gears.   His old bike was much too small for him so my husband decided to get him his birthday present well in advance of his December birthday so he could use it while the weather was still nice outside.  This morning my husband put it together and this afternoon my son was off with his friends on his new bicycle.

The Tiny Girl Chronicles:   My daughter doesn’t know what she wants for her birthday.   We had some ideas but so far we’re not sure what to get her.   She says she wants a second purple yoga ball and another tigger stuffed animal.   But since she already has one of each of those, we’re going to try and find another option.