High Eye Pressure: Symptoms, Causes, Diagnosis, and Treatment
Intraocular Pressure (IOP), also called eye pressure, is the pressure exerted by aqueous humor inside the eye. This pressure is vital for the healthy working of the eyes. However, a constant elevation in eye pressure can enroot several eye conditions, such as Glaucoma, which can cause vision loss.
Therefore, it is crucial to deeply understand the symptoms, causes, diagnosis, and treatment of high eye pressure to protect your eyesight. This article will discuss everything about elevated eye pressure to reduce the risks of developing a vision-threatening eye condition.
What is high eye pressure?
High eye pressure is also known as Ocular Hypertension. In general, the normal eye pressure is 10 to 21 mm Hg. When the eye pressure exceeds its upper limit, it is considered high eye pressure or high Intraocular Pressure (IOP). This condition doesn’t necessarily cause symptoms or damage initially, but it is a significant risk factor for developing Glaucoma, a disease that can lead to optic nerve damage and vision loss. Elevated eye pressure can cause different forms of Glaucoma, such as:
- Open-angle Glaucoma: When the drainage angle remains wide open, but the fluid does not drain properly and increases eye pressure
- Closed-angle Glaucoma: This happens due to the bulging of the iris that completely blocks the drainage angle and causes elevation in eye pressure
- Normal-tension Glaucoma: The exact cause of this type of Glaucoma is less known. However, a fragile or sensitive optic nerve can get damaged even at normal eye pressure
In some cases of Glaucoma, eye pressure can exceed 70 mm Hg, beyond the normal range. Therefore, routine eye examinations are recommended to keep a medical record of one’s eye condition and detect early symptoms of disease.
High eye pressure symptoms
According to the American Academy of Ophthalmology, no particular signs and symptoms of elevated eye pressure exist. People may not notice any significant change in their eyesight until it is too late. However, people may start noticing a few symptoms when the eye condition caused by elevated eye pressure progresses.
People can spot some changes in the progression of Glaucoma. In the early stages of Open-angle Glaucoma and Normal Tension Glaucoma, the condition is asymptomatic. However, people can notice peripheral and central vision loss as the eye condition progresses.
Closed-angle Glaucoma can show the following symptoms:
- Severe headache
- Blurred vision
- Redness in eyes
- Pain in eyes
- Halos or rainbow-coloured rings
What causes high eye pressure
Several reasons can cause elevated eye pressure. Some of the reasons are:
Imbalance in aqueous humor and drainage
The eye produces a clear fluid called aqueous humor, which fills the front part of the eye and helps maintain its shape. This fluid is continuously produced by the ciliary body, a structure behind the iris. After circulating through the front part of the eye, the aqueous humor drains out through a complex network called the trabecular meshwork, located in the drainage angle between the iris and cornea.
An imbalance occurs when:
- Overproduction of aqueous humor: The eye may produce more aqueous humor than it can effectively drain. This excess fluid increases the volume inside the eye, leading to higher IOP
- Inefficient drainage: The trabecular meshwork may become less efficient at draining the aqueous humor. This can be due to age-related changes, inflammation, or other conditions that affect the drainage system’s functionality
Eye trauma (injury)
According to NCBI, about half a million people worldwide are blind due to eye injuries. Also, in populations under 25 years of age, eye trauma is the leading cause of visual blindness. All types of eye trauma can elevate eye pressure inside the eyes and cause several chronic eye conditions if they are not treated earlier. Sometimes, minor eye injuries are not treated for months and can increase eye pressure.
Certain medications
According to the American Academy of Ophthalmology, steroids can be harmful for people with Glaucoma, as they can increase their eye pressure. Moreover, topical cycloplegics have been shown to elevate eye pressure by 2% in normal populations and up to 23% in people with Glaucoma.
Antibiotics (sulfa drugs) are also shown to induce Glaucoma by elevating eye pressure in people. Furthermore, some cardiac agents can elevate eye pressure and increase the risks of developing Glaucoma within three weeks of the medications.
Diagnosis of high eye pressure
Here are some of the eye tests (Tonometry) to check your eye pressure and early detection of an eye condition:
Goldmann Applanation Tonometry (GAT)
This painless test is the ‘gold standard’ test for measuring your eye pressure. Firstly, your doctor will anesthetize (numb) your eyes and apply non-toxic dye to your eyes. Then the slit will gently touch the front of your eye and records the force required to flatten a fixed area of your cornea.
Pneumatonometry
This eye pressure benefits people with corneal scars because this method does not use anesthesia. The device consists of a hollow tube and senses the air pressure. During the corneal applanation (flattening), the pressure inside the tubes increases to match the pressure generated by the eye. This pressure gets traced to the strip of paper.
Rebound Tonometry
It is one of the widely used methods and does not require anaesthesia. This test measures the deceleration of the bouncing back of the plastic probe depending on the eye pressure. Moreover, people can also use Sensimed triggerfish contact lenses to record their daily eye pressure fluctuations by measuring changes in the shape of the cornea.
High eye pressure treatment
After diagnosing the eye pressure and finding the underlying cause behind its elevation, your doctor can recommend the following treatment measures:
- Prostaglandins: These eye drops are effective in increasing the outflow of fluid and, thus, decreasing eye pressure
- Beta-blockers: They reduce fluid production to decrease elevated eye pressure
- Carbonic anhydrase inhibitors: These reduce the amount of fluid production in the eyes
- Rho kinase inhibitor: These medications are helpful in increasing the outflow of aqueous humor and stabilizing the eye pressure
For severe cases, laser surgery and trabeculoplasty can also help to drain the aqueous humor from the eyes and reduce high pressure in the eyes.
Conclusion
Eye pressure is the pressure exerted by aqueous humor inside your eyes. Disturbance in the amount of fluid produced and drained can cause high eye pressure. It can lead to eye problems, including vision-threatening Glaucoma. There are no particular symptoms of elevated eye pressure in the initial stages. However, as the condition progresses, individuals can experience some changes, such as blurred vision and pain in the eyes.
Elevated eye pressure can be caused due to medications, eye injury, and fluid buildup in the eyes. Therefore, getting a routine eye test with Goldmann Applanation Tonometry and other methods to detect eye changes is crucial. After diagnosis, your doctor can recommend eye drops or surgical treatments to reduce the eye pressure and treat your eye condition.
Frequently Asked Questions
Can high pressure cause headaches?
Yes, high pressure can cause headaches. As Glaucoma progresses, people can notice sudden changes, including headaches in Closed-angle Glaucoma. You should consult your doctor and seek medical treatment to prevent its progression.
How to diagnose high eye pressure?
Your doctor can check your eye pressure with the help of Goldmann Applanation Tonometry, pneumatonometry, and rebound tonometry. To keep a close check on your eye pressure, you can consult your doctor and opt for Sensimed triggerfish contact lenses.
What happens when your eye pressure is high?
If your eye pressure is high for a long time and you do not get treatment, it can damage your optic nerve and cause Glaucoma. An untreated Glaucoma can cause permanent loss of vision. Therefore, you should consult your doctor in case of elevated eye pressure and prevent eye conditions.
What are the symptoms of high eye pressure?
There are no signs or symptoms of increased eye pressure in people. You may be unable to detect the changes in your eyes until it’s too late. Therefore, it is recommended to get routine eye check-ups and seek medical treatment to avoid any serious complications.
What are the treatment options for high eye pressure?
If your eye pressure is above normal, your doctor may recommend some eye drops. These eye drops typically include Prostaglandins, beta-blockers, carbonic anhydrase, and rho kinase inhibitors. If your eye pressure still does not improve, laser therapy can be used to drain out the fluid.
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