Questions and Answers

Question:
I had cataract surgery done and also have glaucoma in the same eye, how long should I wait before practicing PPT?

Answer:
You should wait three months.

Question:
I had surgery on the right eye, can I practice PPT on the left eye while waiting for the right eye to recover from surgery?

Answer:
Yes,  you can but it will be better to wait one week to avoid Valsalva maneuver that may cause bleeding from the wound.

Question:
In people with the nearsighted eye, will practice PPT regularly reshape the roundness of the eyeball?

Answer:
Yes, if someone practice PPT daily, it will flatten the Anterior-Posterior diameter of the eyeball, result in decreasing myopia up to 1.00 diopter in adult and may stop or reduce myopic progression in children.

Question:
If I stare at my computer screen or cellular phone screen for long time, will the action damage my eyes?

Answer:
Yes, the damage can occur in different segments of the eye:

1. It starts with the effect on the anterior portion of the eye.  Due to a long session of an intense visual task at the screen with less frequent of eye blinking, the irritated eyes become dry, red, and scratchy, resulting in the dryness of the cornea.

2. Long-term effect,  the posterior segment of the eye will be affected causing two pathologies:
  • Macular dysfunction and degeneration
  • Accelerate chronic glaucoma progression rate especially in the patient with a history of hereditary glaucoma.
Practicing PPT  2 1/2 minutes for every hour of using the computer will relieve the short-term condition and prevent the long-term effect.

Question:
Will practice PPT daily increase intraocular pressure (IOP) and aggravate glaucoma condition?

Answer:
Practicing PPT will not increase IOP nor cause any harm due to these 3 factors:
  1. The correct technique of PPT is to apply pressure slowly, so IOP will slightly and briefly arise, following by the declining due to the forceful drainage of the aqueous humor through trabecular meshwork.
  2. Trabecular meshwork in the eyeball helps regulate the IOP by allowing the outflow of the aqueous humor to exit to maintain a constant pressure in the eye
  3. The flexibility of the sclera helps diminish the pressure from practicing PPT.
Regular application of PPT can permanently maintain normal IOP in glaucoma patient.

Question:
At what level, the eyeball pressure considers high?

Answer: When the intraocular pressure (IOP) rises higher than 21 mm.HG

Question:
Can high or low blood pressure contribute to the cause of chronic glaucoma?

Answer: No,  unless the patient has extreme high blood pressure with systolic over 200 mm.Hg which may also cause stroke or severe low blood pressure that causes syncope.  In glaucoma patient, Lamina cribrosa regulates intraocular pressure.

Question:
Why no pulsation found in retinal artery in normal eye?

Answer:
This is a good question as blood vessels have pulsation throughout the body, why not in the eye.

To understand this phenomenal, one has to understand the mechanism behind the eyeball.  When light enters the eye, it projects on the photoreceptors (rod and cone cells).  The photoreceptors transform the light into electrical nerve impulses in the retinal cell layer before sending through optic nerve fiber to process in the brain.

 If pulsation occurs in the retinal cell layer, the transformation of the light into the electrical nerve impulses will be disturbed.  The interference affects the interpretation of the picture in the brain.  For this reason, the body uses Lamina Cribrosa at the optic nerve head to regulate the IOP and intracranial pressure.  The variation of Lamina Cribrosa strength creates a risk of visual impairments,  such as ischemic neuropathy and optic atrophy when Lamina Cribrosa is too strong.
 
Question:
What regimens were being used in practicing of PPT?
 
Answer: There are 3 modalities including in PPT as necessary per case basis:
1. Laser photocoagulation - to help closure the leakage of the retina vein
2. Prednisolone - to help relieve swelling of the retina
3. PPT - to improve blood flow from Retina

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