Fluids Hypertension Syndromes: Migraines, Headaches, Normal ...

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 99
16. Hyperopia 234 52.1 27.4% 9.8% 6.0% 2.6% 18.4%
17. Menstrual migraines 95 33.4 36.8% 13.7% 3.2% 1.1% 17.9%
18. Astigmatism 286 38.7 24.8% 5.2% 9.4% 3.1% 17.8%
19. Excessive Computer or
TV
20. Sleeping with one arm
over the eyes
57 29.3 42.1% 7.0% 5.3% 1.8% 14.0%
0 - - - - - -
No Migraines 339 38.9 21.8% 5.9% 2.9% 2.1% 10.9%
21. Ocular Surgeries - - - - - - -
Table X-1: Etiologies of Glaucoma related with their respective glaucomatous damage (glaucomatous
Optic neuropathy), from the 1,270 patients. We marked boldface the biggest numbers.
Each patient can have one or more Etiologies or Risk Factors simultaneously.
There is relation between Myopia and Glaucoma: “Mean intraocular pressure was approximately 0.5
mmHg higher in myopic eyes compared to nonmyopic eyes. This study has confirmed a strong relationship
between myopia and glaucoma. Myopic subjects had a twofold to threefold increased risk of
glaucoma compared with that of nonmyopic subjects. The risk was independent of other glaucoma risk
factors and intraocular pressure.” (Mitchell P, and others).
When the patient came just in time. We had a 34-year-old man, 1.65 meters (5 feet and 5 inches)
tall, weighting 55 kilograms (121 pounds), white, with almost all ancestors from Turkey and only one
great-great-grandfather Black He was complaining about a right temporal daily migraine at afternoons,
for the last three years. From 15 days until now, he is complaining of aches, redness and small
edema at his left eye. He was a drinker of coffee of only two ounces (60 milliliters) twice a day, Guaraná
only at weekends, and 3,000 milliliters (near one gallon) of water daily. For headaches, he took
two tablets of caffeinated analgesic daily. On the ophthalmological exam, we found shallow anterior
chambers, intraocular pressures of 17 and 16 mmHg right and left eyes (which is in the physiologic
limit), and all the rest was normal. His Optic Nerve’s disks show 0.5/3/1/0.25 and 0.6/3/3/0.5 right and
left eyes (cup diameter/ cup depth/ lamina cribosa’s pores visibility/ borders edema), which means that
both eyes presented damage consequent to the rise of intraocular pressure, together with the rise of the
Cerebrospinal fluid pressure. The left eye we classified as suspect of glaucoma.
After stopping the coffee, the guaraná and shortening the daily water, all aches vanished without
medication. Probably he will not evolve to the advanced glaucoma.
Typically, we see that he suffered from both Ocular and Cerebrospinal Fluid Hypertension on the
same time, but not on the same daily hours. Typically also, is that the Cerebrospinal Fluid Hypertension
did not cause definitive damage on his Optic Nerves, it caused only edemas, but the Ocular Hypertension
caused the progressive and cumulative disk damage that can evolve to the glaucoma after
many years.
We conclude that all the 20 above Etiologies or Risk Factors can cause the Normal (Peak) Tension
Glaucoma, besides the migraines, signs and symptoms they cause. The etiologies to the Migraines
and to the Normal (Peak) Tension Glaucoma are the same. The distinctions between the etiologies’
incidences are only statistical.
When occasionally there is a peak of high intraocular pressure caused by one or more of these etiologies
acting together, the Optic Nerve damages, but no physician measures this high intraocular pressure
at that moment, and he denominates the patient’s aches as migraines. After many years, when examining
the patient on the medical office, the ophthalmologist finds the glaucoma and the intraocular pressure
lowered to its normal levels, and then he denominates this as a Normal Tension Glaucoma. It is indeed
a Peak Tension Glaucoma.
We denominated all the migraines, variants, signs, symptoms and glaucoma consequent to the occasional
ocular hypertension, as the Ocular Hypertension Syndrome.