Is Eye Pressure High If My Eyes Feel Swollen? Symptoms and Concerns

Is a feeling of puffiness in the eyes indicative of high intraocular pressure?

Hello, I often feel pain and pressure in my left eye, along with headaches, so I saw two ophthalmologists last month.
The first doctor measured my eye pressure using a puff test, which showed (left) 30 and (right) 28.
However, the doctor said there was no problem.
He mentioned that the puff test can sometimes yield high pressure readings.
I then underwent structural eye examinations and visual field tests, and he also said everything was normal.
Still feeling uneasy, I decided to see a more renowned ophthalmologist (I had seen this doctor in June of last year for the same issue.
At that time, the puff test showed left 23 and right 21, and after dilating my pupils, it was 16.
He said I did not have glaucoma, and my fundus was normal).
This time, the puff test results with this doctor were (left) 25 and (right) 23, and after using the eye drops, it was 20, with no issues found in the fundus.
He also stated that I do not have glaucoma but that I have moderate dry eye syndrome.
However, I still worry frequently.
I read online that pressing on the eye can give a rough estimate of eye pressure; if it feels hard, the pressure might be high.
I often press on my eyes, but I still feel that my left eye is often swollen.
Sometimes, using dry eye drops seems to make it feel softer, and after rubbing my eyes or showering, it also feels softer.
But at times, it still feels swollen.
When I wake up, I feel tightness in my eyes, as if I can't open them.
After waiting for 1-2 minutes, it goes away (I experienced these symptoms last year, which is why I consulted a doctor then).
I would like to ask if these symptoms could indicate glaucoma? Do I need to see a doctor again? If my eyes feel swollen, does that mean the eye pressure is high? (There is no headache or anything).
Additionally, why do massaging the eye acupoints, rubbing my eyes, and using dry eye drops make my eyeballs feel softer? I often feel pressure in my eyes, but after rubbing and massaging the area around my eyebrows a few times, it quickly feels softer.
However, after a while, it becomes slightly swollen again.
If swollen eyes indicate high eye pressure, does that mean my eye pressure is constantly high? I remember that in June of last year, my left eye felt more swollen, but I can't compare it to how it feels now because I don't remember.
Thank you, doctor.
I am really worried; I am only 17 years old.
I often worry about having different illnesses.
Also, is this pressing method accurate? Because the ophthalmologist said I shouldn't press directly on the eyeball, as it is not accurate.
However, when I saw my family doctor, he used the pressing method to help me assess my condition (the family doctor said there was no issue when he pressed on my eyeball).

jh, 10~19 year old female. Ask Date: 2020/04/22

Dr. He Jianxian reply Ophthalmology

Hello, using finger pressure to measure intraocular pressure is absolutely inaccurate, and even very experienced physicians do not use this method to assess eye pressure.
The sensation of eye fullness usually comes from tension in the surrounding eye muscles, and appropriate rest and massage can help relieve it.
Dr.
He Jianxian, Nantou Hospital.

Reply Date: 2020/04/22

More Info

It sounds like you are experiencing a lot of anxiety regarding your eye health, particularly concerning the possibility of glaucoma and high eye pressure. First, it's important to understand that feeling of swelling or pressure in the eyes can be caused by various factors, and it does not necessarily indicate high eye pressure or glaucoma.

1. Understanding Eye Pressure and Symptoms: High eye pressure (intraocular pressure) is a significant risk factor for glaucoma, but it is not the only indicator. Symptoms such as a feeling of swelling or pressure in the eyes can be due to several reasons, including dry eyes, eye strain, or even sinus issues. The fact that your eye pressure readings have varied but have been deemed normal by multiple eye care professionals is a reassuring sign. The measurements you provided (30, 28, 25, 23, and 20 mmHg) indicate fluctuations, but the lower readings after dilation suggest that your eye pressure can be managed and is not consistently high.

2. Dry Eyes and Eye Strain: You mentioned having moderate dry eye syndrome, which can cause discomfort, a feeling of pressure, and even headaches. Dry eyes can lead to a sensation of swelling or tightness, especially upon waking. Using lubricating eye drops can help alleviate these symptoms. Additionally, if you spend a lot of time on screens, you may be experiencing digital eye strain, which can also contribute to discomfort and feelings of pressure.

3. Self-Assessment of Eye Pressure: It is not advisable to self-assess eye pressure by pressing on your eyes. This method is not accurate and can potentially harm your eyes. Eye pressure should be measured using specialized equipment by a trained eye care professional. The fact that your family doctor used this method does not align with standard practices in ophthalmology, which rely on tonometry for accurate measurements.

4. When to Seek Further Evaluation: If your symptoms persist or worsen, it is reasonable to seek further evaluation. You should not hesitate to consult with an eye care professional if you feel that your concerns are not being addressed or if your symptoms change. Regular check-ups are essential, especially given your history of fluctuating eye pressure and dry eyes.

5. Managing Anxiety: It’s understandable to feel anxious about your eye health, especially at a young age. Consider discussing your concerns with your eye doctor, who can provide reassurance and guidance. They can explain your condition in detail and help you understand the signs to watch for that would warrant immediate attention. Engaging in relaxation techniques, such as mindfulness or deep breathing exercises, may also help manage your anxiety.

6. Conclusion: In summary, while your symptoms may be concerning, they do not necessarily indicate high eye pressure or glaucoma, especially given the normal readings from your eye exams. Focus on managing your dry eyes and reducing eye strain, and do not hesitate to reach out to your eye care provider if you have ongoing concerns. Regular monitoring and open communication with your healthcare providers are key to maintaining your eye health.

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