Glaucoma Tips
Chat Highlights
March 5, 2003

Ken Parker, Editor

On Wednesday, March 5, 2003, the glaucoma chat support group discussed "GlaucoTips."

Moderator:  Tonight we will be sharing tips with each other.  I have some questions for everyone to start out.  First, let's talk about instilling eye drops.  Does anyone have any tips on remembering when to put your eye drops in?

P:  I have a tip for the morning.  In the morning I use the snooze to help time my drops.  First ring, first drop, second ring, second drop.

P:  I keep them with the toothbrush so I can't get to my teeth without seeing the drops, which I use before bed.

Moderator:  How about tips for remembering which one you have put in, that is if you need to take more than one drop?

P:  Day drops - rubber band to the coffee pot, night drops to the tooth brush or whatever your pre-bed ritual is.

Moderator:  I like the coffee pot reminder!

P:  Biggest to smallest for me.

P:  I remember mine by colors.   They have an order.  Blue, then red.  Every time the same order.  I also keep mine in my pockets.  Left side means I did not put the drop in yet.  Right side means I put the drop in.

P:  It's easy for me--just one drop first thing in the morning.  I keep it on the bedside table and do it as soon as I wake up.

P:  I no longer use drops, but when I did, I always used them in the same order.

P:  I have a problem with keeping track when there are several things to do. I just put everything at one end of the counter. Then after use, set it down at the other and keep going until everything is at the same end.

P:  You can put them toward the back of the counter after instilling and then move them closer toward you. This way you know which one you put in.

Moderator:  Any tips on telling the difference between bottles of eye drops if you have decreased vision?

P:  I remember Dr. Rick saying he told patients with decreased vision to use rubber bands around the bottles to distinguish them.

P:  The shape of the bottle helps, too.

Moderator:  Does anyone have any other tips for instilling eye drops they would like to share?

P:  I use handkerchiefs instead of tissues. They are softer and feel better than tissues when putting in my drops.

P:  My husband, who is retired, puts my three different drops in at 8:00 AM and 8:00 PM. I guess right now I'm lucky, I don't know what you do if you have to put drops in yourself. I have trouble doing it myself, although there are times when I have to.

Moderator:  How about just the actual act of instilling them. Any tips for newer users from us veterans?

P:  I have the bottles numbered, ie: #1, #2, #3.

P:  We use the same order all the time, too.

P:  Use your finger as a guide.

P:  Occlude, occlude, occlude.

Moderator:  I find it hard to occlude the whole time. I real quick put a drop in, and then occlude.

P:  Explain "occlude," please.

Moderator:  Punctal occlusion.  Pressing the puncta (tear duct) closed where the inner eye meets the nose.

P:  Make a pocket in your lower lid.  Instill the drop into the pocket.

P:  I put mine in standing up.  In the bottom eye lid sac, in front of the mirror, and then occlude.

P:  Do you occlude before putting the drop in?

P:  I begin occluding even before instilling the drop, then add a tissue as soon as possible.  I occlude where the upper and lower eyelids meet, on the inside, by the nose. Then I press towards the nose, fairly hard.

P:  Press gently, don't pinch.  Pinching could squeeze out the drops.

P:  I put in my own drops.  I am supposed to put in one drop.  I am never sure I put in only one.

P:  I find Alphagan the most difficult to use. It tends to spread around.  By the way, I used to occlude for three minutes, but have cut it down to 2 minutes.  Either way, it takes almost a half hour to install three different drops.

P:  When I give eye drops, I aim for the inner part of the eyes, then I can get the drops in without touching the persons eye.

Moderator:  OK, new topic gang.  Does anyone have any tips for taking visual field (VF) tests?

P:  I haven't had a VF test since last June, 2002, but I know I don't like them.  I find them very stressful.

P:  Don't get uptight about them!  They're just a tool for the doctor to use.

Moderator:  Be a duck, just let stuff roll off your back.

Moderator:  A fellow glaucomate has always told me to blink often.

P:  I like to have time after they patch my eye, so I can adjust to the darker room and the one eye being patched.

P:  On a VF test, do the most critical eye first.  Your attention is much more acute.  You are less tired on the first eye.

P:  Hands up all those who LIKE visual field tests.

Moderator:  I like them because they are a valuable tool.

P:  Hands down.

P:  I have no problems whatsoever with them, but I make sure I don't have any coffee before I take the test, so I'm not jittery.

P:  What is a visual field test like?

Moderator:  Visual field is a test they perform to check your field of vision.  I think it is a simple test to take.

P:  You just press a button when you see a light.

Moderator:  Kind of like a video game, you have a button to press and when you see a light, you hit the button.

P:  Be careful not to have the patch pushing up against your eye.  Make sure that the cup is centered correctly.

P:  No big deal.  The machine maps out your visual field.

P:  If you get tired hold the button in and take a rest.

Moderator:  Don't be afraid to tell the technician you need a rest.

P:  Ask the technician if the machine has a pause feature.  If so, ask how it works and when you should use it.

P:  I think of it as a video game, which I have lots of experience. :) Try to keep focused, stay comfortable and ignore outside sounds.

P:  Ask your doctor to go over the test with you, to explain it and your results.

P:  Keep a copy for your own records!

Moderator:  Does anyone have any tips for keeping one's own records?

P:  I get a copy of all the tests I take, visual fields, HRT's, etc, and keep a file.

P:  I have a schedule/check-off list for my drops.  I save them.  Over time they tell me what I was taking and when.

P:  I do have copies, but make sure you ask before the test so they can easily just print a second copy.

Moderator:  Good point.

P:  I have a computer file with my IOP's since diagnosis.

Moderator:  Does anyone have any tips for preparing for a visit with eye doctor?

Moderator:  My tip for a visit to the doc...be a duck and let stuff roll off.  No need to worry until there is something to worry about.

P:  Write out questions. That is what I have been doing.

Moderator:  Good one.

Moderator:  Know all your current medications, including those not for glaucoma, any medications you take.

P:  In addition to field test records and such, I also keep my own record of IOP readings, along with notes about who did the measuring (technician or doctor), time of day, and so on.  Also keep my own record of the drops I've used.  These actually turned out to be helpful not long ago when I had to switch medications.  Yes, the doctor had the same records, but I think I was more intensely focused on them.

P:  If I have specific questions, I email him ahead of time so he knows what I want to know.

Moderator:  You have a great relationship with your doctor!

P:  My husband takes notes as the doctor is speaking. I can't rely on remembering everything he says.

P:  I find that if I schedule a doctor's visit at the end of the day, he's more inclined (and able) to spend time with me and answer my questions.

Moderator:  Does anyone have any tips on how to find information on the Internet?

P:  Google! Google!

P:  I like Google also.  For even more detailed and medical information, I also use Pubmed (free Medline info).

P:  Wills website!

Moderator:  This site has a search engine and you can search the chat highlights.

P:  I have found lots of articles at Google.  In search, type in subject, e.g. ocular circulation. etc. I find lots of good stuff.  I cut and paste into Word document, save, print and read when I have time.

P:  You could just bookmark them or put them in "favorites?"

Moderator:  Does anyone use amber or yellow eye shades, if so, can you share with the group why and how they help?

P:  I have amber wrap-arounds.  They have yellow clip-ons, too.

Moderator:  What does the amber do? Why do they help?   Does amber help sun glare?

P:  Yellow increases contrast and amber cuts blue light.

P:  Yellow and amber are both good.  You can get inexpensive ones that flip up, too.

P:  They cut down on glare and help with vision problems.  I spend a lot of of time in the Florida sun looking up at the R/C airplanes overhead in a bright blue sky.

P:  They help me with light sensitivity.  If I wear amber I can even see in the shade.  They also seem to have better clarity.

P:  Are your yellow glasses prescription?   Where does one buy yellow lenses?  Are they good for night driving?

P:  No.  Bought them in a gas station for about $7.00.   Dr. Robert Ritch recommended Corning's yellow shades.  Can't remember the number.

P:  I found insert yellow lenses that hang on inside of the nose-piece of glasses (like they give after dilation) for $2.50 at my doctor's office's optician.

Moderator:  Ok, how about we start to talk about coping and talking with others about our glaucoma, etc?

P:  I tend to have a sense of humor when I come to chat. ONLY TIME :) helps with coping....just kidding

P:  I agree.  But you have to have a sense of humor more often.

Moderator:  I also like to travel.  I don't do it often but like to see new places as a way to cope.

P:  I haven't told my brother or daughter, yet.

Moderator:  I told people right away, I was scared and was talking to anyone who would listen. Do you not know what to say? Are you afraid of what they will think?

P:  I am a lot less panicked now than I was two weeks ago when I found out.  Knowledge (even bad stuff) helps.  They will be panicked and I just have to feel I can handle it.  I told two close friends and my husband knows.

P:  Why wouldn't you tell relatives?  This is a genetic disease.  Let them know their risk and what can be done about it!

P:  Personally, I haven't wanted to tell too many people.  It seems sort of like admitting you have leprosy -- to others, I mean.

P:  Of course, I will tell them very soon -- just as soon as I figure out how.

P:  I have told relatives, however, and all the ones I told went and had their eyes checked.

P:  For me the telling was easy.  It's getting people to listen that's the hard part.

P:  I have been telling people my whole life about glaucoma.

P:  I just want to tell them more than "I have glaucoma," I have been researching extensively.

Moderator:  Yes, the more you know about your own glaucoma the better.

P:  My brother has a congenital retina problem.  He can see very little with one eye.  I am just waiting to see him in person to tell him, next week.

P:  Being a GlaucoMate helps with coping, doesn't it gang?

Moderator:  I totally agree.

P:  Yeah!!!

P:  Right!

P:  GlaucoMates changed the way I treated my glaucoma.

P:  We are a pretty analytical family.  They will have a lot of questions, most of which I haven't thought of so I am actually anxious to get their input

P:  Few people even know what glaucoma is.  They think all you need to do is put in a few drops and that's it.

P:  I would certainly not tell anyone at work.  It is so easy chatting with you all.

P:  I was out of work for 11 weeks after surgery last year.  So everyone there knew.  I think people have their own problems and tend to forget.  I'm not handicapped.

Moderator:  I told coworkers, they are a good means of support for me, when times are bad.

P:  I have found people want to know, but in bits and pieces.  It can get complicated.

P:  I once had a job and was told not to tell anybody and to take my medications in the bathroom.

P:  I guess, then, it's MY fear that others will regard me as handicapped.

P:  I am a big guy, construction worker size, they don't see anything wrong with me until I bump into them!

P:  I think others see you as you see yourself and project that image.  If you go around saying "woe is me" that's the reaction you'll get from others.

P:  Good point.

P:  Right.

P:  I don't want it to influence any work that is assigned to me or interfere with a promotion I expect soon.  I know lots of lovely people outside work.  I don't tell people who are my age at work either.

P:  Well, I'm a graphic designer, so I think I've felt people might think I'm unable to do the work.

Moderator:  My employer made me read a book in front of the nurse before I could come back after surgery.

P:  Sometimes I need help from someone to tell me what is not visible to me, but I don't make a big deal out of it or tell them why I can't see it.

Moderator:  What kinds of things?

P:  A sign in the distance or too small printing or just anything.  Sometimes I do have blurriness and that makes for some problems just getting around.  But people are willing to help and they don't ask questions.

P:  I work in electronics and solder in parts that are almost too small to see.

P:  Thanks for all the great ideas/coping, etc. Night all :)

Moderator:  Good night gang.

End of highlights for March 5, 2003.

On March 12, Dr. Wilson discussed "Normal-tension Glaucoma" in the Chat room. Click here for highlights of that meeting.

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