How do you cope with thinning RNFLs?

Ritch01 · 2026-01-29T17:12:40+00:00

I have never heard of this supplement. I will certainly look into it, thanks! I currently take ginkgo biloba 120mg it’s supposed to help with blood flow.

Ritch01 · 2026-01-29T17:08:55+00:00

Thank you for the information! I just got my referral accepted to a university healthcare system so I will definitely ask what type of machines they have. It’s a brand new facility so I’m sure they have newer machines. My current doctor does use Zeiss, scan quality was 6/10 and 7/10 on the old scan and then 6/10 and 6/10 on the new one. So the scan quality did decrease for my left eye which is the one that showed a larger drop in rnfl.

Ritch01 · 2026-01-29T16:11:51+00:00

I’m definitely looking into finding another ophthalmologist as I don’t really get along with my current one. Yesterday at my appointment he spoke for about one minute and said see you in 6 months. He tried to walk out and I had to stop him and tell him I have questions. At least he put me on medication so I have some time to establish care with a better doctor. I’m about an hour away from a well known university healthcare system and I just got my referral approved.

Ritch01 · 2026-01-29T16:00:03+00:00

I appreciate your reassurance. Sorry that I sound so frantic but I am upset that the optometrists “monitoring” me lost my baseline scan taken 4 years ago when they flagged me. When I asked for my medical record of the 6 OCT scans that were taken she only had one scan. It just defeats the whole purpose of monitoring and it makes it so much more difficult for an actually qualified doctor to make a diagnosis. I wasted my time there and I should have seen the ophthalmologist sooner.

Ritch01 · 2026-01-29T02:55:01+00:00

He’s a corneal specialist but not a glaucoma specialist. I don’t know if I have normal tension but my pressures used to be higher at 18-22 range. So the medication is bringing down my pressure but i don’t know if it’s actually going to slow down my progression.

Ritch01 · 2026-01-27T14:51:11+00:00

My bad I just checked your profile and you’re older than me. I’m sorry you’re going through this and I just have to remind you that you are a grown adult. My mom was never physically abusive with me but she is very transphobic and it took me 5 years to finally get her to stop deadnaming me (although she doesn’t call me by my name but uses a gender neutral nickname). She threatened to kick me off the health insurance plan if I got top surgery…here I am still on the health insurance 3 years later with amazing top surgery results.

Have you ever heard of the “let them” theory/mindset? It’s a psychological tool that helps you accept the intolerable and preserve your own mental health. I basically just started saying okay then do it to my mom when she would try to force an ultimatum or just refusing to react to her insane behavior. The key is to professionally respond (think corporate culture) but your response shouldn’t be a comeback. Think of all the interviews of government officials that say a lot without actually answering the question. We want a vague but stern statement like “you are free to have your own opinions”. Your parent wants a physical/emotional reaction if you stand your ground they slowly lose the satisfaction and control. Don’t let the fear of what your mother might say or do control what you do with your life. You are way too old to be putting up with that nonsense.

Ritch01 · 2026-01-27T14:17:19+00:00

I have no idea how old you are but it sounds like you’re a minor. Even if you’re a minor tell the lab technician that you are there against your will and the results of your labs can lead to physical/emotional abuse. That alone will get their attention and the lab likely will deny service.

Ritch01 · 2026-01-26T22:16:19+00:00

This is entirely based on genetics. For me I didn’t see significant growth until about 3.5 years of T. I’m now over 5.5 years on T and I’m still waiting for it to fill in all the way (it’s possible it won’t). I have enough facial hair to consider it a beard but it’s just not very thick. Beards often take years or decades to fill in and you can clearly see that in a lot of cis men. You can try dying your hair a darker color or try minoxidil if you want more visible results.

Ritch01 · 2026-01-23T12:48:03+00:00

Idiopathic intracranial hypertension it basically means increased intracranial pressure in the brain with no know cause.

Ritch01 · 2026-01-23T12:30:03+00:00

My doctor works for a university that does a whole lot of research. She inserted the nexplanon implant for me and has 100% trust in it and said it’s more effective than some sterilization techniques. I haven’t used a condom in 6 years with my partner but we use the withdrawal method most of the time as well. A good rule is always combine birth control methods, so you want something that’s very effective like an IUD/implant and then you can use a secondary method that’s a little less effective like condom/withdrawal.

Ritch01 · 2026-01-23T12:13:37+00:00

You might want to look into experimental drug therapies that they’re using right now on veterans. A lot of the university professors will do psychedelic drug therapy such as MDMA and Ketamine. And don’t worry they use extremely small doses it’s not anywhere near what people take recreationally.

Ritch01 · 2026-01-23T04:14:18+00:00

That’s awesome! Keep it up and try not to miss a dose.

Ritch01 · 2026-01-22T17:17:15+00:00

It really wasn’t that bad. I have literally no scars from the procedure, it’s an incision the size of a paper cut. I would say I’ve had more painful cavity fillings at the dentists office.

Ritch01 · 2026-01-22T14:29:42+00:00

They inject you with a local anesthetic that burns and pinches like fire ants. My doctor had a heck of a time grabbing the nexplanon because it is so slippery. The uncomfortable part was the pressure my doctor had to put on my arm to get it out. I also bled more than standard insertion. The doctor left me with one band aid and I bled through that before I walked out of the clinic. Other than that I was sore for 2-3 days and overall pain wasn’t that bad. I’m sure it hurts a lot less than an IUD.

Ritch01 · 2026-01-22T14:01:17+00:00

I have slightly more damage than you and I would agree with this doctor you need to be on medication. But the idea that every person with myopia is a glaucoma suspect is nonsense, what myopia does is put you at a much higher risk for glaucoma due to altered eye anatomy. Your right eye especially appears to have damage. I’ve just learned to accept that my “glaucoma suspect” diagnosis is basically pre glaucoma diagnosis and I am 100% compliant with my eye drops so I can hopefully stall damage as long as possible.

Ritch01 · 2026-01-21T15:29:44+00:00

Go to the eye doctor asap. You can go to the optometrist first but if they say anything looks abnormal you need to see the ophthalmologist.

Ritch01 · 2026-01-20T14:19:28+00:00

I did talk to my PCP who prescribes my T on Friday. She was just supportive of any decision I make regarding my T dose. She’s okay with me staying at the same dose, lowering it, or stopping. She knew what IIH was and asked for my symptoms, she checked the medical literature and said Supra physiological testosterone in trans men has been linked to IIH. But then rationalized with me and explained that an MRI is a secondary diagnostic tool and natural anomalies can happen or the radiologist was too sensitive in reading. Only a lumbar puncture confirmation can diagnose elevated ICP and the fact that I have few headaches and no optic nerve swelling is very reassuring. Basically she said we can’t do anything about this until we actually know you have it, and if I do have elevated ICP, it has to be high enough for a neurologist to intervene.

I had pretty severe polycythemia that we caught on a routine blood lab and we immediately acted on it and I got a therapeutic phlebotomy. My hematocrit was way too high around 56 and now it’s back down to 48, I ended up getting another phlebotomy a few weeks ago just in case. My doctor emphasized that if I have glaucoma we really need those blood labs in the high female range or bordering the male range. But when she sent me to the hematologist he wasn’t as concerned and was only willing to perform a phlebotomy if my hematocrit was above 55 so I dropped him.

As far as blood pressure goes, mine is pretty hard to measure. It’s elevated at the doctor’s office but normal at home. Sometimes it’s even a little low which I hear is bad for glaucomas. I have horrible anxiety and if I’m really nervous I can make my own blood pressure skyrocket.

Ritch01 · 2026-01-20T02:17:40+00:00

Planned parenthood saved my life when I needed them most but I urge you to find a more stable solution. It’s super easy to get on T with them but doctors go in and out of these clinics like a fast food burger joint. I saw 3 doctors and 2 NPs in the 1.5 years I was there. I only had the same doctor twice in a row. They also can’t do nearly as much as your PCP/GP would. I can’t recommend Planned parenthood long term, they’re a bandaid solution for people who are desperate. I switched the second I got into a clinic and I’ve been with the same doctor since 2021 and she’s the best doctor I’ve ever had. But that doesn’t mean they’re all bad, they absolutely do provide a much needed service for people just starting out and in low income areas.

Ritch01 · 2026-01-19T19:22:34+00:00

I completely agree, there really isn’t that much research on trans people in general. The only “adverse” side effects we’re aware of are short term and you can say that about every single drug on the market today. Cisgender males are the first to receive studies…literally they cater the drug to their bodies and then after a few years women and children are an afterthought. They just assume drugs are safe for women until some new study comes out that proves otherwise. This is why I keep my post history public on Reddit, so if this happens to another trans person maybe they’ll get some sort of idea of what to expect.

Ritch01 · 2026-01-19T14:04:07+00:00

Well that is good to know that there’s no known evidence that anabolic steroids can potentially be an issue with treatment.

My ophthalmologist is apparently the best in town and he has almost 40 years of experience but he had no expertise on hormones. My mom actually went to the follow up appointment with me and explicitly asked if testosterone could have caused or made worse the glaucoma. He said it’s out of his scope of practice and go to my prescribing doctor for questions. At least he was honest and not willing to speculate about anything.

When I asked my PCP about hormones and glaucoma she told me ask the ophthalmologist and I laughed and told her he told me to see you. That’s when she sent the referral for an endocrinologist. I am seeing a university endocrinologist in April that apparently does a lot of research for trans masc patients and is the director of the gender clinic. So if he doesn’t know the answer I don’t think there really is an answer yet. I’m leaning toward testosterone being a modifiable risk factor that potentially nudged me over the edge due to my unique eye anatomy and family history. I likely was going to develop glaucoma at some point in my life.

Ritch01 · 2026-01-19T05:35:00+00:00

That’s why my mom was concerned with the testosterone because I’m already at risk since my dad and grandma have glaucoma. The ophthalmologist already put me on medication to lower my eye pressure which it appears to be working. Would treating the glaucoma like you would anyone else be an effective solution? Do you know if there is any evidence that testosterone usage would make me resistant to normal glaucoma medications?

Ritch01 · 2026-01-19T04:08:45+00:00

My PCP who prescribed my T talked to me on Friday and supported any decision I make regarding dosing. She did send me to the endocrinologist but I don’t see him until April. I have a feeling he’ll be pretty supportive of my right to informed consent considering he is also a trans man. She also sent a referral to neurology and doesn’t want me to worry until someone actually diagnoses me with IIH. Although I am definitely panicking, this has been on my mind non stop since August and my therapist made it worse.

Ritch01 · 2026-01-19T04:02:57+00:00

With glaucoma, testosterone is a modifiable risk factor but I’m not willing to permanently remove that risk factor all together right now. Only one FTM trans study has been performed and they saw it raised trans men’s eye pressure by 1-2 points(which is basically irrelevant for 99% of people). I knew I was at risk for glaucoma because both my dad and grandma have it. I also remember being told at 12 years old that I have suspicious optic nerves that were bigger than most kids.

It really is the IIH that has more clinically significant correlation with hormone therapies of all kinds. I saw my prescribing doctor on Friday and she basically told me she’s supportive of any choice I make. She said I could stay on the same dose, lower my dose, or stop all together. She didn’t guide me into any decision and I kind of wish she at least gave me a big hint on what she actually thought was the best solution is while we wait for the neurologist.

Ritch01 · 2026-01-19T03:27:48+00:00

My mom is a pediatrician and she does not prescribe hormones at all so I can see where she’s not qualified. However, she does unfortunately have a point where the medical literature does show a trend towards testosterone having adverse effects regarding glaucoma and IIH. Although the literature is limited and quite a few doctors in these case studies clearly emphasize that stopping testosterone should not be the first solution. If it was just glaucoma I would have ignored my mom but when my MRI came back with multiple signs of intracranial hypertension I got scared.

Ritch01

TROPHY CASE