help please! Eye pressure question - my own test results

Discussion in 'Ophthalmology: Eye Physicians & Surgeons' started by John P, May 20, 2014.

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  1. John P

    John P

    May 20, 2014
    I am new to this forum, so first off - hello everyone!

    I am not an Opthalmology student, but I am hoping for some advice / opinions based on some recent eye tests that I have had. To not bore everyone with a length post, here is the summary:

    1. Visit to Opthalmologist one
    - IOP reading right eye 23.5, left eye 23.5 (using a Goldmann tonometer)
    - Central Corneal Thickness (CCT) right eye 329, left eye 606
    - peripheral field test within normal limits
    - referred to a glaucoma specialist

    2. Visit to Opthalmologist two (Glaucoma specialist)
    - IOP reading right eye 19.2, left eye 19.2 (using a Goldmann tonometer), true IOP ~14.8
    - CCT right eye 609, left eye 609
    - 3D optic nerve tomography normal
    - Grade 2-3 open angles, both eyes
    - told no issues

    3. Visit to Opthalmologist three (another Glaucoma specialist), for a 3rd opinion
    - IOP reading right eye 21.8, left eye 18.5 (using an Ocular response analyzer - the air puff machine)
    - CCT right eye 401, left eye 599
    - prescribed daily eye drops to reduce pressure in the right eye

    My question is, how can all of the Central Corneal Thickness tests be so variable for one eye and not the other? How accurate are the ultrasound machines that measure thickness? Obviously I would prefer not to use any medication if I can avoid it. All tests were taken within a few days of each other.

    Any help / opinions would be greatly appreciate. Thanks.
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  3. PBEA

    PBEA Senior Member 10+ Year Member

    May 28, 2004
    like any instrument they need periodic recalibration.........but there might not be anything wrong with the machines

    there are many reasons why corneal thickness may be fluctuating
  4. OphthoApp

    OphthoApp 7+ Year Member

    Sep 30, 2008
    You cannot ask for advice on this website.
    bkz likes this.
  5. orbitsurgMD

    orbitsurgMD Senior Member 10+ Year Member

    Dec 27, 2005
    [The following is not medical advice.]

    Whenever there is a significant inter-eye difference in CCT, that is an indication for a re-measurement, if necessary by an alternate method. I use Oculus PARK-1 ARs that perform pachymetry using the Scheimpflug imager. If I get an inconsistent read, I use an ultrasound to remeasure. There needs to be a plausible reason for a 300 micron difference in CCT, otherwise it should be remeasured.

    The Goldmann is accurate only to within +/- 2 mmHg, so I am curious how you got decimal reads in the tenths of a mmHg. (19.2, 23.5) I question this.

    "Air puff machine" at a glaucoma subspecialist's office? Whatever.

    And as others said, this is not the place to go for medical advice.
    Last edited: May 22, 2014
  6. hurdlepup

    hurdlepup Surviving Intern Year 7+ Year Member

    Feb 11, 2010
    On Country Roads
    Do you live in Oklahoma?
    bkz likes this.
  7. Winged Scapula

    Winged Scapula Cougariffic! Staff Member Lifetime Donor SDN Chief Administrator 10+ Year Member

    Apr 9, 2000
    hSDN Member
    SDN is not for medical advice. Closing.

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