Ocular Hypertension

Definition:

Ocular hypertension is a condition characterized by higher than normal pressure (21 mm of hg) measured in one or both eyes on 2 or more occasions. Optic nerve is normal with no signs of glaucoma in persons with intraocular hypertension but they are definite suspects of glaucoma and should be closely monitored.

Facts about Intraocular Hypertension

• Not associated with optic nerve damage or any other ocular disease
• Untreated high eye pressure can lead to optic nerve damage, hence permanent vision loss

Risk factors of Ocular Hypertension

Although eye pressure of any individual can rise, but individuals with following factors are at high risk of developing ocular hypertension:

• Family history
• Diabetes
• Age above 40 years
• African-American descent
• Myopia
• Thinner-than-normal central corneal thickness

Causes of Ocular Hypertension

Rise in ocular hypertension can occur due to following causes:

• Excessive aqueous production
• Inadequate drainage of aqueous
• Injury to the eye
• Certain eye diseases including pseudoexfoliation syndrome, pigment dispersion syndrome and corneal arcus
• Certain medications (such as steroids)

Ocular Hypertension Symptoms

Ocular hypertension is a condition that does not show any signs or symptoms in the person. But to avoid any vision or eye related complication due to undiagnosed ocular hypertension, it is important to undergo regular eye examinations with the ophthalmologist.

Ocular Hypertension Diagnosis

Diagnosis of ocular hypertension not only requires a comprehensive eye examination, but other eye tests too to measure intraocular pressure and screen glaucoma or other eye disorders. The tests include the following:

• Tonometry to measures the pressure in the eye
• Gonioscopy to get a clear look at the drainage angle of the eye
• Ophthalmoscopy to inspect optic nerve for signs of damage using an ophthalmoscope
• Visual field test to check for blank spots in vision
• Pachymetry to assess the thickness of the cornea

Treatment of Ocular Hypertension

More than treatment, close monitoring is required in cases of ocular hypertension to reduce any chances of vision loss or damage to the optic nerve. This is done in cases with marginal rise of eye pressure.

But for individuals with high eye pressure, ophthalmologist may decide not to initiate treatment to reduce the intraocular pressure. One or more pressure-lowering eye drops are prescribed. The effect of medication is monitored by regular visit to ophthalmologist to test eye pressure within several weeks.

In some cases where eye drops are ineffective in reducing eye pressure, ophthalmologist might recommend glaucoma treatment measures, including glaucoma surgery, to treat high eye pressure.

Follow up of Ocular Hypertension

All cases of high intraocular pressure should be monitored regularly from every two months to yearly, depending upon the pressure frequency. This is especially required as individuals with high intraocular pressure are considered “Glaucoma suspects” and should be regularly examined for other signs of glaucoma to prevent sudden loss of vision.

Outlook of Ocular Hypertension

The prognosis of individuals with ocular hypertension is very good provided it’s managed well with medication and regular follow up. Compliance with medical treatment as prescribed by ophthalmologist does not let the disease progress to primary open-angle glaucoma. On the other hand, poor control of elevated intraocular pressure, continuing changes to the optic nerve and visual field can lead to glaucoma and sudden loss of vision.