Managing High Eye Pressure and Dry Eye Syndrome: Key Questions Answered

Q: Managing High Eye Pressure and Dry Eye Syndrome: Key Questions Answered

Hello Miss Mei：<br>1. <br>The use of intraocular pressure-lowering medications should be based on a high suspicion of glaucoma. <br>If the corneal thickness is normal but intraocular pressure is elevated, and there are defects in visual field testing or abnormalities in OCT exami

High intraocular pressure + dry eye syndrome

Previously, my intraocular pressure was 23-24.
The doctor prescribed me Iopidine, bottled artificial tears, bottled eye drops, and tear film ointment, along with self-paid single-dose artificial tears.
After a month, during my follow-up appointment, my eye pressures were 20 and 23.
Therefore, the doctor prescribed an additional bottle of Iopidine, while the other medications remained the same.

So I would like to ask:
1.
Will the two bottles of intraocular pressure-lowering eye drops affect dry eye? Will they make my eyes drier?
2.
I have already purchased single-dose artificial tears.
If I also use the bottled artificial tears and eye care drops prescribed by the doctor, will this reduce the need for steroids? Or do I still need to use the bottled ones in addition to the single-dose? Will using more single-dose artificial tears provide better results?
3.
Is it suitable to use a rechargeable heated eye mask for high intraocular pressure? What is the appropriate temperature? Should the eye mask apply pressure to the eyeball, or is it sufficient for it to lightly touch the eyes?
4.
Currently, my intraocular pressure has reached a maximum of 25, while the rest fluctuate between 20-23.
Does this mean I will need to use intraocular pressure-lowering medication for life?

mei, 30~39 year old female. Ask Date: 2021/01/06

Dr. He Jianxian reply Ophthalmology

Hello Miss Mei:
1.
The use of intraocular pressure-lowering medications should be based on a high suspicion of glaucoma.
If the corneal thickness is normal but intraocular pressure is elevated, and there are defects in visual field testing or abnormalities in OCT examination, please confirm these conditions before considering glaucoma medications.
2.
The use of artificial tears by workers does not have a strict guideline based solely on the user's subjective symptoms; however, it is recommended that preservative-containing artificial tears should not be used more than four times a day.
3.
If using a product for warm compresses on the eyeball, it is advised to avoid applying pressure to the eyeball.
Director He Jianxian, Ophthalmology, Nantou Hospital

Reply Date: 2021/01/06

More Info

Managing high eye pressure and dry eye syndrome can be a complex issue, especially when considering the interplay between medications, symptoms, and overall eye health. Here are the answers to your questions based on the information provided and general medical knowledge.

1. Impact of Eye Pressure Medications on Dry Eyes: The medications prescribed for lowering eye pressure, such as prostaglandin analogs (like Travatan) or beta-blockers, can sometimes have side effects that may exacerbate dry eye symptoms. For instance, some eye pressure medications can reduce tear production or alter the composition of tears, leading to increased dryness. If you notice that your eyes feel drier after starting these medications, it’s important to discuss this with your eye doctor. They may consider adjusting your treatment plan or suggest additional lubricating eye drops.

2. Using Multiple Artificial Tears: Combining different types of artificial tears can be beneficial, especially if you are experiencing dry eyes. The single-use artificial tears you purchased can be used alongside the bottled artificial tears prescribed by your doctor. The key is to ensure that you are using them appropriately throughout the day to maintain moisture. However, if you are using a steroid eye drop (like Fluorometholone), it’s crucial to follow your doctor’s guidance on how to use it in conjunction with artificial tears. Generally, you can use artificial tears before or after applying steroid drops, but you should wait at least 10-15 minutes between applications to avoid washing out the medication.

3. Use of Heated Eye Masks: Using a heated eye mask can be beneficial for dry eyes, as heat can help to unclog meibomian glands and improve oil secretion in the tears. This can be particularly helpful if your dry eyes are due to meibomian gland dysfunction. The ideal temperature for a heated eye mask is typically around 40-45 degrees Celsius (104-113 degrees Fahrenheit). When using the mask, it should rest gently on your eyes without applying pressure. The goal is to provide warmth and comfort, not to press down on the eyeball.

4. Long-term Management of High Eye Pressure: If your eye pressure readings are consistently in the range of 20-25 mmHg, it is essential to continue monitoring and managing your eye health. While some individuals may require lifelong treatment to maintain healthy eye pressure, others may find that their pressure stabilizes with lifestyle changes or adjustments in medication. Regular follow-ups with your eye doctor are crucial to assess the effectiveness of your treatment plan and make necessary adjustments. Your doctor will consider factors such as your overall eye health, the presence of any symptoms, and the risk of developing conditions like glaucoma when determining the best course of action.

In summary, managing high eye pressure and dry eye syndrome requires a comprehensive approach that includes regular monitoring, appropriate use of medications, and lifestyle adjustments. It’s essential to maintain open communication with your eye care provider to ensure that your treatment plan is tailored to your specific needs and that any side effects are addressed promptly.

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