Persistent Eye Pressure and Blurred Vision: Seeking Answers After Multiple Exams

Elevated intraocular pressure with blurred vision, but after six visits to the ophthalmologist, it has been deemed normal?

Hello, doctor.
I have high myopia (over 600 degrees in both eyes).
In May 2021, I started experiencing frequent eye fatigue, floaters, and blurred vision.
I delayed seeking help until September when I visited a small clinic.
Due to my work environment, I often use a computer and stay in air-conditioned rooms, and I also spend my time in an air-conditioned dormitory after work.
Additionally, I have symptoms of incomplete eyelid closure.
Initially, I had four visits to the clinic where my intraocular pressure was measured (15, 16; 18, 17) and my fundus examination was normal.
At first, I thought it was dry eye syndrome, but using artificial tears and resting did not improve my condition.
One night while driving, the headlights made me feel nauseous, and now I experience photophobia and halos around lights.
Realizing something was wrong, I quickly went to a large hospital in the city for a detailed examination, but both my fundus and intraocular pressure were normal.
A few days later, I went to a medical center for further evaluation.
The fundus and intraocular pressure remained normal, but my tear production was low (about 5-7) and the doctor indicated that my eyes were lacking oil.
However, the examining physician mentioned that my optic nerve seemed particularly thin, raising suspicion of glaucoma, and recommended a visual field test, which came back normal.
Consequently, I was prescribed only artificial tears and ointment.
After the visit, my eyes still feel swollen, and I am genuinely concerned that I might be experiencing early signs of glaucoma, either angle-closure or open-angle.
I am quite anxious about my situation.
Doctor, how do you assess my condition?

Niming, 20~29 year old female. Ask Date: 2021/10/28

Dr. Liang Ce reply Ophthalmology

It is recommended that you discuss the above situation with your attending physician to determine if further examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2021/10/28

More Info

Your situation involves multiple factors that can contribute to your symptoms of persistent eye pressure, blurred vision, and discomfort. Given your history of high myopia (over -600 diopters in both eyes) and the recent symptoms you’ve described, it’s essential to consider several aspects of your eye health.

1. High Myopia and Eye Health: High myopia can lead to various complications, including retinal detachment, macular degeneration, and glaucoma. The thinning of the retina and changes in the optic nerve can occur in individuals with high myopia, which may explain the concerns about your optic nerve appearing "thin." Regular monitoring is crucial, as these conditions can progress without noticeable symptoms until significant damage has occurred.

2. Symptoms of Eye Fatigue and Blurred Vision: Your symptoms of eye fatigue, floaters, and blurred vision can be attributed to several factors, including prolonged screen time, dry eyes, and possibly the effects of high myopia. The use of air conditioning can exacerbate dry eye symptoms, leading to discomfort and visual disturbances. It’s important to take regular breaks from screens (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds) and consider using artificial tears to alleviate dryness.

3. Eye Pressure and Glaucoma Concerns: Although your eye pressure readings (15, 16, 18, 17 mmHg) are within the normal range, the concern about glaucoma arises from the appearance of your optic nerve and your symptoms. Glaucoma can occur even with normal eye pressure, known as normal-tension glaucoma. The visual field test results being normal is reassuring, but continued monitoring is necessary. If there are changes in your visual field or optic nerve appearance over time, further investigation may be warranted.

4. Pupil Response and Light Sensitivity: Your symptoms of light sensitivity (photophobia) and halos around lights can be associated with dry eyes, but they can also indicate other issues, such as corneal irregularities or even early signs of glaucoma. The discomfort you experience when driving at night due to oncoming headlights could be exacerbated by dry eyes or the effects of high myopia.

5. Management and Follow-Up: Given your ongoing symptoms and the complexity of your case, it’s advisable to maintain regular follow-ups with your ophthalmologist. They may recommend additional tests, such as optical coherence tomography (OCT) to assess the optic nerve and retinal layers more thoroughly. If you continue to experience symptoms, discussing the possibility of seeing a specialist in glaucoma or a retinal specialist may be beneficial.

6. Lifestyle Adjustments: In addition to medical management, consider lifestyle adjustments to help manage your symptoms. Ensure you stay hydrated, use a humidifier in dry environments, and practice good screen hygiene. Wearing protective eyewear when using screens can also help reduce strain.

In conclusion, while your current tests indicate that there is no immediate concern regarding glaucoma, your symptoms and history warrant close monitoring. Regular eye exams, attention to your symptoms, and proactive management of dry eye can help maintain your eye health. If you have ongoing concerns or if your symptoms worsen, do not hesitate to seek further evaluation from your eye care provider.

Similar Q&A

Persistent Eye Pain After Trauma: When to Seek Further Medical Attention

Hello, Doctor. Last week, I experienced significant pressure on my left eye. Two days ago, I felt some blurriness in my vision and went to the clinic. The doctor measured my vision and said it had decreased by about two diopters. They performed a fundus examination (with dilation...

Dr. Gao Pilin reply Ophthalmology
Hello: If you are experiencing persistent eye pain and seeing transparent floaters, and you have already undergone a fundus examination under the guidance of a physician with no issues found, but the symptoms continue, I recommend that you seek further evaluation. Since your eye ...

Understanding Morning Blurry Vision: Causes and When to Seek Help

Hello Doctor, sometimes when I wake up in the morning, my vision is blurry. Sometimes it's in both eyes, and sometimes just one eye. Usually, the blurry vision in both eyes resolves within a few minutes, but the blurry vision in one eye can last for a whole morning or even a...

Dr. Gao Pilin reply Ophthalmology
Hello, Miaomiao: 1. It could be a different issue. 2. This kind of blurred vision is difficult to diagnose without an examination. 3. If it is due to high intraocular pressure, it is important to get checked promptly to avoid complications. I recommend getting an examination as s...

Managing Eye Pressure: Understanding Strabismus, Fatigue, and Treatment Options

Hello, Doctor. On June 29, my intraocular pressure was measured at 21/20, and on August 23, it was 21/19. This time, the doctor prescribed me a pressure-lowering medication (Xingkelong 2%). When I had my pressure checked on September 2, it was 17/16. At that time, I asked the doc...

Dr. Gao Pilin reply Ophthalmology
Hello Wan: 1. Uncertain. 2. Pulling it back forcefully may compress the eyeball, leading to increased intraocular pressure. 3. Surgical correction may be considered. 4. It could be caused by strabismus. 5. Uncertain. 6. Possible. 7. It should not be significant, but if corticoste...

Understanding Eye Pressure, Brain Pressure, and Vision Loss: A Patient's Journey

Hello, doctor. Since 2021, I have been regularly monitored at a hospital in central Taiwan due to elevated intraocular pressure. During this period, my eye pressure was normal for a while. After returning to Taipei in March 2023, I continued to have my eye pressure monitored at T...

Dr. Jiang Junyi reply Neurology
Dear Mr. Huang, You mentioned that "high intracranial pressure" is often associated with significant and dangerous conditions. It is important to distinguish between acute and chronic increases in intracranial pressure. In cases of acute intracranial hypertension, pati...