Is Self-Testing Eye Pressure Reliable? Your Eye Health Concerns

Is the finger prick method accurate?

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 could yield high pressure readings, and then I underwent examinations of the eye structure and visual fields, which he also deemed normal.
Still, I was not reassured, so I consulted a more renowned ophthalmologist (I had seen this doctor in June of the previous year for the same issue.
At that time, the puff test showed left 23 and right 21, and after using dilating drops, it was 16.
He said I did not have glaucoma, and my fundus was normal).
This time, the puff test with this doctor showed (left) 25 and (right) 23, and after using the drops, it was 20, with no issues in the fundus.
He confirmed that I do not have glaucoma but mentioned that I have moderate dry eye syndrome.
However, I still often worry.
I read online that pressing on the eye can roughly estimate eye pressure; if it feels hard, the pressure might be high.
I frequently press on my eyes, but I always feel that my left eye is swollen.
Sometimes, using dry eye drops seems to make it feel softer, and after rubbing my eyes or showering, it also feels softer.
But sometimes it feels swollen again.
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 saw a doctor then).
I would like to ask if these symptoms could indicate glaucoma? Do I need to see a doctor again? Does a swollen feeling in the eye mean high eye pressure? (There is no headache associated with it.) Additionally, why does massaging the eye acupoints, rubbing my eyes, and using dry eye drops make my eyeball feel softer? I often feel pressure in my eyes, but after rubbing and massaging my brow area a few times, it quickly feels softer.
However, after a while, it becomes slightly swollen again.
If a swollen feeling indicates high eye pressure, does that mean my eye pressure is constantly high? I remember that in June of last year, when I pressed on my eyeball, my left eye also felt more swollen.
But I can't compare it to now because I don't remember the sensation.
Thank you, doctor.
I am really worried; I am only 17 years old.
I often worry about having different diseases.
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 assess my condition (the family doctor said it felt fine when he pressed on my eyeball).

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

Dr. Cai Wenyuan reply Ophthalmology

Is the finger measurement method accurate? Please do not attempt it.

Reply Date: 2020/04/22

More Info

Self-testing eye pressure can be a concerning topic, especially for individuals who experience symptoms like eye pain, pressure, or headaches. Your situation highlights the importance of understanding how eye pressure is measured and the reliability of self-assessment methods.

Firstly, it's essential to recognize that eye pressure, or intraocular pressure (IOP), is a critical factor in diagnosing conditions like glaucoma. However, measuring eye pressure accurately requires specialized equipment and trained professionals. The most common methods for measuring IOP include applanation tonometry (like the Goldmann tonometer) and non-contact tonometry (often referred to as "air puff" tests). These methods are designed to provide precise measurements under controlled conditions.

Your experience with varying eye pressure readings from different doctors is not uncommon. Factors such as anxiety, the method of measurement, and even the time of day can influence IOP readings. For instance, non-contact tonometry can sometimes yield higher readings due to the nature of the test, which involves a puff of air that can cause temporary fluctuations in eye pressure. It's also worth noting that IOP can vary throughout the day, so a single measurement may not provide a complete picture of your eye health.

Regarding self-testing by pressing on your eyes, this method is not reliable. While you may feel that your eye is "hard" or "soft," this tactile assessment cannot accurately reflect your IOP. Eye doctors advise against pressing on the eyeball because it can potentially cause damage and does not provide a valid measurement of pressure. The sensation of pressure or discomfort you feel could be related to other factors, such as dry eye syndrome, which you mentioned you have. Dry eyes can lead to discomfort and a feeling of pressure, but they do not necessarily indicate high IOP.

Your symptoms of feeling pressure in your left eye and experiencing headaches warrant further investigation, especially since you have a history of anxiety about your eye health. While your eye doctors have indicated that your IOP is within normal ranges and that you do not have glaucoma, it may be beneficial to follow up with them if your symptoms persist or worsen. They can conduct a comprehensive examination, including visual field tests and optical coherence tomography (OCT), to assess the health of your optic nerve and rule out any potential issues.

In terms of managing your anxiety about eye health, consider discussing your concerns with your healthcare provider. They can offer guidance on coping strategies and may refer you to a mental health professional if needed. Understanding the nature of your symptoms and the results of your eye examinations can help alleviate some of your worries.

In summary, while self-testing eye pressure by pressing on your eyes is not a reliable method, it is crucial to rely on professional assessments for accurate measurements. If you continue to experience discomfort or have concerns about your eye health, seeking further evaluation from an eye care professional is advisable. Remember, maintaining open communication with your healthcare providers about your symptoms and anxieties can significantly contribute to your overall well-being.

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