Having high pressure in the eye, also known as intraocular pressure or IOP, can potentially lead to a serious eye condition called glaucoma. Glaucoma damages the optic nerve which transmits visual information from the eye to the brain. Increased IOP is a major risk factor for developing glaucoma, so monitoring and controlling eye pressure is important for protecting vision. This article will examine what causes high eye pressure, symptoms, how it is measured, treatment options, and tips for prevention.
What causes high eye pressure?
The front part of the eye contains a watery fluid called aqueous humor which nourishes the eye. This fluid is constantly produced and drained out of the eye to maintain a normal pressure. IOP rises when drainage is blocked and the fluid builds up. There are a few potential causes:
Too much aqueous humor production
The ciliary body behind the iris produces aqueous humor. Sometimes it makes too much which cannot drain properly leading to excess fluid accumulation.
Impaired drainage
There is a drainage system of structures in the eye that allow fluid to leave the eye and enter the bloodstream. If the drain is clogged or does not work effectively, outflow decreases causing IOP to increase.
Narrow angle closure
The drainage angle formed by the cornea and iris can be abnormally narrow. This blocks fluid from reaching the drain and exiting the eye.
Medications
Certain prescription and over-the-counter medications like corticosteroids, antidepressants, and acne treatments containing isotretinoin can increase eye pressure as a side effect.
Underlying health conditions
Diseases like diabetes and hypothyroidism are associated with higher IOP. Eye infections or injuries can also obstruct fluid outflow.
Symptoms of high eye pressure
In the early stages, increased IOP does not cause any symptoms. As it rises higher, some people may experience:
– Blurry vision
– Halos around lights
– Headache or brow pain
– Redness in the eyes
– Nausea/vomiting
If extremely high, it can cause sudden severe eye pain along with seeing colored rings around lights. This acute angle closure attack requires immediate medical help to prevent permanent vision loss.
However, symptoms can be vague or minimal so the only way to detect elevated IOP is through a comprehensive eye exam. Even without symptoms, high pressure can silently damage vision over time. That’s why regular eye check-ups are recommended.
How is eye pressure measured?
Eye pressure is measured by tonometry, a standard part of an eye exam. There are different methods:
Air puff test
A puff of air is blown at the eye. Sensors analyze how the cornea changes shape to estimate the pressure. This non-contact tonometer is the most common method used.
Applanation tonometry
The surface of the cornea is lightly touched with a prism or probe. The force needed to flatten the cornea indicates the pressure level inside the eye.
Handheld tonometry
Portable digital tonometers allow patients to monitor their IOP at home. The device uses an electromagnetic force to indent the cornea and calculate pressure. Results can be shared with the eye doctor.
Schiotz tonometry
A specialized plunger-like device applies weight to the eye, gauging pressure based on the indentation created. This method is less commonly used now.
IOP is measured in millimeters of mercury (mm Hg). Normal range is typically considered between 10-21 mm Hg. Readings above 21 mm Hg are often classified as ocular hypertension. However, there can be some natural fluctuation throughout the day.
IOP Levels
| IOP Range (mm Hg) | Category |
|---|---|
| Less than 10 | Low pressure |
| 10-21 | Normal pressure |
| 21-30 | Elevated pressure (ocular hypertension) |
| 30 and higher | High pressure |
Treatment options for high eye pressure
If IOP is above the normal range, treatment may be recommended to lower and control pressure. This helps prevent damage to the optic nerve and vision loss from glaucoma. Options include:
Medicated eye drops
These are typically the first line treatment. Different types of prescription eye drops can reduce fluid production or improve drainage:
– Prostaglandins – increase fluid outflow
– Beta blockers – decrease fluid production
– Alpha agonists – both decrease fluid and increase drainage
– Carbonic anhydrase inhibitors – decrease fluid production
Consistency is key – eye drops only work if used daily as prescribed. Side effects are generally mild like red eyes or stinging.
Oral medications
For patients unable to use eye drops, carbonic anhydrase inhibitor pills may be prescribed to reduce IOP.
Laser procedures
Laser surgery can open up the drainage angle or make small holes in the iris to facilitate fluid outflow. This provides an immediate pressure-lowering effect.
Surgery
If medications and laser treatment are insufficient to control IOP, incisional glaucoma surgery may be done. This involves creating an alternate passageway to drain eye fluid and bypass blockages. Common procedures include trabeculectomy and drainage implants.
Tips for managing eye pressure
In addition to getting consistent treatment, here are some tips for keeping eye pressure in a healthy range:
– Exercise regularly – aerobic activity may help lower IOP
– Maintain a healthy weight – obesity is linked to increased risk
– Limit caffeine intake which may raise IOP temporarily
– Quit smoking – it restricts blood flow to the optic nerve
– Sleep with head elevated to allow fluid drainage
– Wear protective eyewear to prevent eye trauma
– Take medications as prescribed and attend follow-up visits
– Learn how to properly instill eye drops to maximize absorption
– Use warm compresses over eyes to help open drainage system
– Manage stress levels through relaxation techniques
Key takeaways
– Increased intraocular eye pressure is commonly caused by inadequate drainage of aqueous humor fluid in the eye.
– There are often no obvious symptoms until pressure rises very high, so regular eye exams are essential.
– Tonometry during eye exams measures IOP to screen for elevated pressure.
– High eye pressure may be treated with medications, laser, or surgery to prevent optic nerve damage from glaucoma.
– Making healthy lifestyle choices can help control IOP. Follow through with treatment plans from your eye doctor.
Conclusion
Intraocular pressure is an important indicator of ocular health. While some fluctuation in IOP during the day is normal, chronically elevated pressure can have serious consequences like permanent vision loss from glaucoma. Monitoring and managing eye pressure is crucial, especially if other glaucoma risk factors are present. With a combination of routine eye exams, adherence to treatment, and healthy lifestyle choices, damage and vision loss can be prevented. Consult an ophthalmologist if concerned about increased pressure, sudden changes in vision, or pain in the eyes. Safeguarding eye health involves being proactive and staying on top of this significant risk factor.