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by Scholten A
(High Eye Pressure, High Intraocular Pressure, High IOP)

Definition

Ocular hypertension is high pressure inside the eye. If left untreated, it can lead to glaucoma and lasting loss of eyesight.

Causes

High eye pressure is caused by fluid build up in the eye. This can happen if the eye makes too much fluid, or the fluid does not drain well. The excess fluid creates high pressure in the eye. In time, this can damage nerves that are needed to see.

Risk Factors

High eye pressure is more common in people over age 40. Other things that raise the risk are:

  • A family history of high eye pressure or glaucoma
  • Having diabetes or high blood pressure
  • Nearsightedness
  • Long term use of steroid medicines
  • Having a thin cornea—the clear outer layer of the eye
  • Eye injuries or eye surgeries 

Symptoms

High eye pressure has no symptoms.

Diagnosis

The doctor will ask about symptoms and past health. An eye exam will be done. A test will measure the pressure in the eye. Other eye tests may be done, such as:

  • Visual field test to look for vision loss
  • Photographs of the optic nerve
  • Gonioscopy—to see if the area where fluid drains out of the eye is open or closed
  • Tests of the nerve fiber layer around the optic nerve

Treatment

The goal is to lower eye pressure before it harms eyesight. The doctor may want to just monitor the eye at first. This means regular eye exams and eye pressure checks.

Treatment may include eyedrop medicine or pills to:

  • Lower the amount of fluid the eye makes
  • Increase the flow of fluid

Sometimes laser treatment or surgery may be used to drain the excess fluid.

Even with treatment, the condition needs to be watched. Regular eye exams and eye pressure checks are important.

Prevention

There are no known guidelines to prevent high eye pressure.

RESOURCES

American Academy of Ophthalmology  https://www.aao.org  

The Glaucoma Foundation  http://www.glaucomafoundation.org 

CANADIAN RESOURCES

The Canadian Ophthalmological Society  http://www.cos-sco.ca  

Glaucoma Research Society of Canada  https://www.glaucomaresearch.ca  

References

Busool Y, Mimouni M, et al. Risk factors predicting steroid-induced ocular hypertension after photorefractive keratectomy. J Cataract Refract Surg. 2017;43(3):389-393.

Ocular hypertension. American Optometric Association website. Available at: https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/ocular-hypertension?sso=y. Accessed May 28, 2021.

Ocular hypertension and glaucoma. Bright Focus Foundation website. Available at: https://www.brightfocus.org/glaucoma/article/ocular-hypertension-and-glaucoma. Accessed May 28, 2021.

Primary open-angle glaucoma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-open-angle-glaucoma. Accessed May 28, 2021.

What is ocular hypertension? American Academy of Ophthalmology website. Available at: https://www.aao.org/eye-health/diseases/what-is-ocular-hypertension. Accessed May 28, 2021.

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