Why does normal tension glaucoma sometimes progress even with a low IOP?

A new study in the British Journal of Ophthalmology found three main risk factors at play.

The study details.

The study included 102 eyes diagnosed with normal tension glaucoma with their pre-treatment IOP at 12mmHg or less. The research team evaluated several demographic and clinical factors as well as baseline diurnal IOP's and 24-hour blood pressure (BP) monitoring.

What did they find?

Over the almost 9 year study period, the team found that 35% of these patients progressed even with a low IOP. When comparing the patients that progressed vs the non-progressors, they found three significant risk factors for progression:
1. Greater diurnal IOP at baseline.
2. Greater fluctuation of diastolic BP.
3. Presence of a disc hemorrhage during follow-up period.

How much diurnal fluctuation are we talking?

In this study, the research team found that a 1 mmHg increase in fluctuation of diurnal IOP was associated with a 60.9% greater chance of glaucoma progression during follow-up. (via)


What options do I have to control my blepharospasm?

We have a new-ish option called Xeomin.

What is it?

Xeomin (pronounced Zeo-min) is similar to Botox in that it's made from the bacteria that causes botulism. Botulinum toxin blocks transmission of acetylcholine from neuron to muscle causing a temporary reduction in muscle activity.

Wait, I thought we could already use this for blepharospasm?

That's kind-of true. It was initially approved in 2010 for the treatment of blepharospasm but only in patients previously treated with Botox. Now, Xeomin can be a first line treatment option. (via)


CVS Health.

The CVS HealthHUB is offering $100 for a diabetic retinopathy imaging. (via)

June is cataract awareness month.

According to Prevent Blindness, cataracts are the leading cause of blindness in the world and there are close to 22.3 million Americans age 40 and older with cataracts.

Want to get an optometry speaking gig?

Here is a new website that can facilitate that process.