High Eye Pressure: Causes, Concerns, and Treatment Options

Q: High Eye Pressure: Causes, Concerns, and Treatment Options

Hello： 1. Unilateral hypertension is also common. 2. The two may be unrelated; pain in the brow area is often associated with trigeminal neuralgia. 3. If the reading of 31 is also elevated, it is advisable to use medication before further examination. 4. <

The issue of elevated intraocular pressure?

Hello, Doctor Gao.
I have high myopia (approximately -800 diopters) and severe floaters (I can see many floaters in both eyes).
Recently, due to frequently seeing small bright spots, I visited an ophthalmology clinic for a fundus examination.
The results showed no abnormalities, but I was informed that my intraocular pressure was elevated (it was normal when measured about a month ago).
However, the OTC examination results looked fine, and the doctor advised me to return in a week for another pressure measurement.
Upon my follow-up visit, the intraocular pressure in my right eye returned to normal (about 18), while the left eye remained elevated (about 31).
The doctor prescribed Cosopt eye drops and instructed me to return in two weeks.
I forgot to ask the following questions during the consultation due to nervousness:
1.
Most people with elevated intraocular pressure seem to have both eyes affected.
What circumstances could lead to elevated pressure in only one eye?
2.
Recently, I have been experiencing soreness in the left brow area.
The pain frequency varies, but it tends to occur when I relax my eyes while looking far away, and sometimes when I close my eyes to rest.
Could this be caused by high intraocular pressure, or could the pain itself be causing the elevated pressure?
3.
The doctor did not diagnose me with glaucoma.
Should I go to a larger hospital for further confirmation, or should I follow the current instructions to use the eye drops to lower the pressure first?
4.
The eye drops prescribed by the doctor seem to be a combination medication.
Does this indicate that my intraocular pressure is significantly elevated, requiring a stronger medication?
5.
How long does sustained high intraocular pressure take to cause damage to the optic nerve? I am concerned that if the pressure does not decrease, it could lead to optic nerve damage.
Thank you for your assistance, Doctor Gao.

Niming, 20~29 year old female. Ask Date: 2022/05/16

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Unilateral hypertension is also common.
2.
The two may be unrelated; pain in the brow area is often associated with trigeminal neuralgia.
3.
If the reading of 31 is also elevated, it is advisable to use medication before further examination.
4.
It may be thought that a single prescription may not lower it sufficiently.
5.
It varies for each individual, depending on changes in visual fields.
Therefore, a visual field test may be necessary first.

Reply Date: 2022/05/16

More Info

Hello! Thank you for your detailed questions regarding high eye pressure and its implications, especially considering your history of high myopia and floaters. Let's address your concerns one by one.

1. Unilateral High Eye Pressure: It is indeed possible for one eye to have elevated intraocular pressure (IOP) while the other remains normal. This can occur due to several reasons, including localized conditions such as a blockage in the drainage angle of the affected eye, differences in corneal thickness, or even anatomical variations. In some cases, conditions like uveitis or trauma can also lead to increased pressure in one eye. Therefore, it’s essential to monitor both eyes regularly, even if only one shows elevated pressure.

2. Pain and Discomfort: The sensation of pain or discomfort around the eyebrow area, particularly if it occurs during activities that require focus, could be related to several factors. High eye pressure can contribute to discomfort, but it is also possible that the pain is due to muscle strain from prolonged visual tasks or even tension headaches. If the pain persists or worsens, it would be wise to discuss this with your eye doctor, as they may want to explore other potential causes.

3. Further Evaluation for Glaucoma: Since your doctor has not diagnosed you with glaucoma, it may not be immediately necessary to seek further evaluation at a larger hospital. However, if you have concerns about your eye pressure or if your symptoms change, it is always prudent to follow up. Continuing to use the prescribed eye drops as directed is essential, as they can help manage your eye pressure effectively.

4. Use of Combination Eye Drops: The fact that your doctor prescribed a combination eye drop does not necessarily mean your pressure is excessively high, but rather that a multi-faceted approach may be beneficial in managing your condition. Combination drops can enhance efficacy and improve patient compliance by reducing the number of medications needed. It’s important to follow your doctor’s instructions regarding the use of these drops.

5. Duration for Nerve Damage: The timeline for potential optic nerve damage due to sustained high eye pressure can vary significantly among individuals. Chronic elevated IOP can lead to glaucoma, which may cause irreversible damage to the optic nerve over time. Some studies suggest that significant damage can occur within a few months to years, depending on the severity and duration of the elevated pressure. Regular monitoring and treatment are crucial to prevent such outcomes.

In addition to addressing your specific questions, I would like to emphasize the importance of regular eye examinations, especially given your high myopia and recent changes in your eye pressure. Maintaining a healthy lifestyle, managing stress, and ensuring adequate rest for your eyes can also contribute positively to your overall eye health. If you experience any new symptoms, such as changes in vision, increased pain, or other unusual sensations, do not hesitate to contact your eye care provider promptly.

In summary, while high eye pressure can be concerning, with appropriate management and regular follow-ups, many individuals can maintain good eye health. Please continue to follow your doctor's recommendations and keep track of any changes in your symptoms. Thank you for reaching out, and I hope this information helps alleviate some of your concerns!

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