I have a strong family history of glaucoma

Q: I have a strong family history of glaucoma. Is there any new information about glaucoma prevention that I should know about?

A: Ocular perfusion pressure (OPP) is the new buzz in glaucoma management. This is the pressure around the optic nerve in order to receive oxygen and keep the nerve fibers alive. OPP is measured by taking your diastolic blood pressure (dBP) minus your intraocular pressure (IOP) and this measurement needs to be over 50 mmHg in order to keep the risk of glaucoma low.

OPP = dBP-IOP

Low diastolic blood pressure while sleeping (supine position) seems to be the largest causative factor for increasing the risk for glaucoma in patients that appear to have normal IOPs. It is no longer just high IOPs that are the concern for glaucoma risk and most patients do not feel they have a problem with their health when they have low blood pressure. You will see most optometry offices are now measuring blood pressure especially with those patients stating they have low blood pressure.

This also affects patients taking blood pressure medications as taking these medications before going to sleep at night can artificially lower the supine diastolic blood pressure much lower and put the optic nerve at risk for many hours while sleeping.

Migraine sufferers have also been studied with this diastolic blood pressure fluctuation and approximately 20% of migraine sufferers fall into this higher glaucoma risk group.

So, paying attention to your blood pressure and how it relates to your eye pressure will help with monitoring for glaucoma.

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Dr. Patricia Fink

OPTOMETRIST

Millcroft Shopping Centre
2080 Appleby Line, Unit E6
Burlington, Ontario, L7L6M6
Tel: (905) 319-1066