The front area of our eyes contains fluid. When these fluids don’t drain properly from your eyes, pressure can build up inside them. Having a higher-than-normal pressure in your eyes is called ocular hypertension.
Ocular hypertension can lead to eye conditions like glaucoma. That’s why it’s important to have regular eye exams that check the pressure in your eyes.
This article will take a closer look at ocular hypertension, what causes it, and how it’s treated.
Ocular hypertension is when the pressure within your eye, called the intraocular pressure, is too high, and there are no signs of glaucomatous damage. One or both eyes can be impacted.
An intraocular pressure of
A person is said to have intraocular hypertension when:
- intraocular pressure is consistently elevated above 21 mmHg
- there’s an absence of clinical signs of glaucoma, such as optic nerve damage or a reduced field of vision
Because ocular hypertension can cause damage to the optic nerve, having elevated pressure inside your eye may increase your risk for glaucoma. However, not everyone with ocular hypertension will develop glaucoma.
What is glaucoma?
Glaucoma is a condition where the optic nerve becomes damaged. As this damage proceeds over time, it can potentially lead to vision loss.
While it’s unknown what causes it, many people with glaucoma have high eye pressure. In fact, applying treatments that lower intraocular pressure can help prevent glaucoma from progressing.
It’s possible for anyone to develop glaucoma, but some people are at a higher risk for the condition. You may be at a higher risk if you:
- have one or more family members with a history of glaucoma
- are over the age of 60
- are Black or Hispanic and over the age of 40
The front of your eye contains a fluid called the aqueous humor. It works to both nourish the tissues in this area and help your eye maintain its shape.
Because your eyes produce aqueous humor constantly, it must be allowed to drain. This happens at an area in the eye called the drainage angle. This drainage system helps to maintain eye pressure by preventing the buildup of aqueous humor.
When aqueous humor can’t drain properly, it begins to accumulate. This increases the pressure within the eye and can lead to ocular hypertension.
Anyone can develop ocular hypertension. However, you may be at an increased risk if you:
- have high blood pressure or diabetes
- have a family history of ocular hypertension or glaucoma
- are over the age of 40
- are Black or Hispanic
- have had eye surgery or an eye injury in the past
- have taken long-term steroid medications
- have certain eye conditions, including nearsightedness, pigment dispersion syndrome, and pseudoexfoliation syndrome
Ocular hypertension typically doesn’t have any symptoms. Because of this, it’s common to have ocular hypertension and not be aware of it.
Your eye doctor uses a simple test to measure intraocular pressure. This type of test is called tonometry.
In addition to doing a tonometry test, your eye doctor may also check for any signs of glaucoma. This can include examining the optic nerve and also checking your peripheral vision.
There are many ways to perform a tonometry test. Let’s look at a few of them in more detail.
Goldmann applanation tonometry
This test involves using numbing eye drops with a fluorescent dye in them. After these are given, a probe that emits a blue light is then gently pressed to the surface of your eye.
The fluorescent dye helps to guide the doctor in determining how much pressure is needed to compress the cornea. The cornea is the outer, transparent part of your eye.
This measurement can then be used to determine intraocular pressure. Basically, the more force that’s needed to compress the cornea, the higher a person’s intraocular pressure is.
In this test, a device blows a quick puff of air onto your eye, which compresses the cornea. The force of the returning air is measured by the device and is converted into an intraocular pressure measurement.
The Tono-Pen is a handheld device that’s used to gently touch the surface of your eye. To determine intraocular pressure, it measures the force needed to compress the cornea. Like Goldmann applanation, numbing eye drops are given before the test is done.
This test is becoming less common as new technology is developed.
Similar to the Tono-Pen, the iCare tonometer is a handheld device. During the test, the probe of the device will gently and briefly touch your cornea to determine intraocular pressure based off of the rebound rate of the probe. Unlike the Tono-Pen, drops aren’t needed for this test.
Ocular hypertension is treated with prescription eye drops that can either help aqueous humor to drain from your eye or lower the amount of aqueous humor that your eye produces. Some examples are:
- prostaglandins (travoprost, latanoprost)
- rho kinase inhibitors (netarsudil)
- nitric oxides (latanoprostene bunod)
- beta blockers (timolol)
- carbonic anhydrase inhibitors (dorzolamide, brinzolaminde)
It’s likely that your eye doctor will schedule a follow-up appointment a few weeks later to see how the eye drops are working.
Additionally, since ocular hypertension increases the risk of glaucoma, it’s important to follow up with your eye doctor every 1 to 2 years for an eye exam.
If your intraocular pressure is only slightly elevated, your eye doctor may wish to continue to monitor it without the use of prescription eye drops. If it remains elevated or gets higher, they may then recommend prescription eye drops.
Surgery for ocular hypertension
For some people, ocular hypertension may not respond well to eye drop medications. In this case, surgery may be recommended to help lower intraocular pressure.
The goal of surgery for ocular hypertension is to create an outlet that allows excess aqueous humor to drain from the eye. This can be accomplished using a laser or more traditional surgical techniques.
Ocular hypertension is when the pressure in your eye is higher than normal, but there are no signs of glaucomatous damage. It can happen when fluids that are naturally produced by your eye don’t drain properly.
Ocular hypertension can lead to damage of the optic nerve. Because of this, people who have ocular hypertension are at a higher risk for developing glaucoma.
Ocular hypertension doesn’t usually have symptoms, so it’s likely that you won’t know that you have it. Getting routine eye exams can help detect and treat ocular hypertension early before it causes any damage or vision loss.