High Eye Pressure (Ocular Hypertension)
- Feb 25
- 2 min read
High eye pressure, also known as ocular hypertension, occurs when the pressure inside the eye (intraocular pressure, or IOP) is higher than normal. While it may not cause immediate symptoms, persistently elevated pressure can damage the optic nerve (the part of the eye that transmit visual infomation to the brain) and increase the risk of developing glaucoma, and causing irreversible vision loss.
Causes
Eye pressure rises when the eye’s internal fluid ( known as aqueous humour) is produced in excess or does not drain well.
Common causes and risk factors include:
Being over 40 years old
Having a family history of glaucoma
Injury to the eye of inflammation affecting the eye
Reduced drainage of fluid (e.g. due to a blockage in the drainage system called trabecular meshwork)
Long-term use of corticosteroid medications
Certain medical conditions, such as diabetes or high blood pressure
It is also possible that there is no single clear cause, or potentially multiple factors contributing to the high eye pressure.
Diagnosis
High eye pressure is usually detected during a routine comprehensive eye exam. Diagnostic methods include:
Air Puff Tonometry - This uses a puff of air to measure the eye pressure.
Goldmann Applanation Tonometry - This uses a physical probe to gently rest on the front of the eye to measure the eye pressure.
Fundus Examination - The optic nerve head at the back of the eye can be examined to look for signs of damage.
Visual Field Test - Checks for peripheral vision loss, which can happen in eyes with high pressure.
Corneal Pachymetry - Measures the thickness of the cornea, which can affect pressure readings; people who have undergone laser correction to the cornea would get a significantly different reading as compared to people with normal corneas.
Because ocular hypertension typically has no noticeable symptoms, regular eye exams are essential for early detection.
Acute High Eye Pressure - An Emergency
Angle-closure glaucoma is a less common but more urgent form of glaucoma that occurs when the drainage angle of the eye suddenly becomes blocked, causing a rapid rise in eye pressure. Symptoms may include severe eye pain, headache, quickly deteriorating vision or blurry vision, halos around lights, nausea, and vomiting. This condition is a medical emergency and requires immediate treatment to prevent permanent vision loss.
Treatment
Not everyone with high eye pressure requires immediate treatment. The decision depends on the pressure and overall risk of developing glaucoma.
Treatment options may include:
Pressure-lowering eye drops to reduce fluid production
Laser to create a hole in the iris to better ensure fluid outflow, if a pupillary block is suspected.
Oral medications
Surgery, if pressure is not well-controlled with other less-invasive methods. There are options like Minimally-Invasive Glaucoma Surgery.
Prognosis
The outlook for people with high eye pressure is generally very good when the condition is monitored and treated appropriately. However, without proper management, sustained high pressure can lead to glaucoma - optic nerve damage and permanent vision loss.
Following up regularly with an eye care professional is the key to preserving long-term eye health.
At risk? Come get your eyes checked with us!
