Ocular Hypertension

What is ocular hypertension?

Fluid present in eyes is called as aqueous humor and pressure caused is called intraocular pressure (IOP). Ocular hypertension means your intraocular pressure (IOP) is higher than normal. Left untreated, high eye pressure can cause glaucoma and permanent vision loss in some individuals.

Eye pressure is measured in millimeters of mercury (mm Hg). Normal eye pressure ranges from 12-22 mm Hg, and eye pressure of greater than 22 mm Hg is considered higher than normal. When the IOP is higher than normal but the person does not show signs of glaucoma, this is referred to as ocular hypertension.

However, people with ocular hypertension are considered “glaucoma suspects”, meaning they should be monitored closely by an ophthalmologist to make sure that they do not develop glaucoma.

How do we know that we have ocular hypertension?

It usually does not have any signs or symptoms. Because you can have ocular hypertension and not be aware of it, it is important that you have regular eye examinations with your ophthalmologist.

Causes

Factors causing are almost similar to glaucoma.
Excessive aqueous humor production, inadequate aqueous drainage, certain medications can have the side effect of ocular hypertension, eye injury, other eye conditions like pseudo-exfoliation syndrome, pigment dispersion, corneal arcus etc. Also, race, age and family history play a role in your risk for ocular hypertension and glaucoma.

Sometimes this can occur months or years after an injury. During your routine eye exams, be sure to mention to your doctor if you have experienced any eye trauma recently or in the past.

Diagnosis

As part of a comprehensive eye examination, your ophthalmologist will perform tests to measure your intraocular pressure and to make sure that you do not have glaucoma. Various investigations include

• Tonometry
• Gonioscopy
• Ophthalmoscopy
• Visual field test
• Pachymetry

Treatment

It is important to monitor it closely and to reduce it before it causes vision loss or damage to the optic nerve.

Initiating treatment is based on ophthalmologist’s decision by regular scheduled testing. In other cases, your ophthalmologist may decide that medication is needed to reduce your intraocular pressure. Pressure-lowering eyedrops can improve your ocular hypertension, but it is important for you to adhere to your prescribed regimen for them to work effectively.

Many patients with ocular hypertension may go on to develop primary open-angle glaucoma, which almost always requires therapy to lower intraocular pressure. If that is the case, your ophthalmologist will discuss treatment options.