High Myopia and Steroid-Related Eye Pressure Issues - Ophthalmology

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Hello! Thank you for your detailed questions regarding high myopia, eye pressure, and the effects of steroid use on ocular health. I understand that these concerns can be quite stressful, especially when dealing with the potential implications for your vision. Let’s address your questions one by one.

1. Does anxiety or stress increase eye pressure?
Yes, anxiety and stress can indeed lead to temporary increases in intraocular pressure (IOP). This is often due to physiological responses such as increased heart rate and blood pressure, which can affect the fluid dynamics in the eye. However, these changes are typically transient. In your case, if your previous measurements were consistently around 17-18 mmHg and have now increased to 20-22 mmHg, it could be a reflection of stress or even the environment in which the measurements were taken. It’s essential to maintain a calm state during these assessments for the most accurate readings.

2. Is a visual nerve measurement of 85 normal for high myopia?
In high myopia, the optic nerve head can appear different due to the elongation of the eyeball. An optic nerve head with a cup-to-disc ratio of 0.85 is considered high and may raise concerns about glaucoma, especially if there are accompanying visual field defects. However, the risk of developing glaucoma in high myopia is indeed higher, but it does not mean you will definitely develop it. Regular monitoring is crucial, and your eye care provider will likely recommend visual field tests and OCT scans to track any changes over time.

3. Can astigmatism and the size of glasses frames affect eye pressure?
Astigmatism itself does not directly influence intraocular pressure. However, wearing glasses with a strong prescription, particularly with large frames, can lead to discomfort or strain, which might indirectly affect how your eyes feel. It’s essential to ensure that your prescription is accurate and that your glasses fit well to minimize any strain on your eyes.

4. What should I do about the increased eye pressure after steroid use?
Steroids can indeed elevate intraocular pressure, particularly in individuals who may be predisposed to steroid-induced glaucoma. The increase to 28 mmHg after using steroid eye drops is concerning, but it’s good to see that it has decreased to 22 mmHg and then to 19 mmHg with continued monitoring. This indicates that your eye pressure is stabilizing, which is a positive sign. It’s crucial to continue monitoring your IOP regularly, especially after steroid use. Your eye doctor may recommend a follow-up in a few weeks to ensure that the pressure remains stable. If the pressure continues to fluctuate or remains elevated, they may consider prescribing pressure-lowering eye drops.

In summary, it’s essential to maintain regular follow-ups with your eye care provider, especially given your history of high myopia and the recent use of steroids. Keeping track of your eye pressure and any changes in your vision will help in managing your ocular health effectively. If you have any further concerns or if your symptoms change, do not hesitate to reach out to your eye care professional. They are best equipped to provide personalized advice based on your specific situation. Thank you for your questions, and I hope this information helps ease your concerns!