Eye Pressure: Should You Worry About Glaucoma?

Q: Eye Pressure: Should You Worry About Glaucoma?

Hello Mr. <br>Liu： There is no need to be overly fixated on the numbers 20 and 21; these are merely indicators representing the threshold close to the average normal intraocular pressure. <br>This serves as a warning sign that there is a possibility of developing glaucoma. <br>Ho

Intraocular pressure issues?

I recently had a health check-up, and my left eye intraocular pressure was measured at 17 mmHg and my right eye at 21 mmHg (using a non-contact tonometer).
I mentioned that I wanted to redo the test because the puff test makes me want to close my eyes or flinch, but the doctor said that the measurements were consistent and didn't require retesting.
He mentioned that these values are at the threshold for monitoring glaucoma, which makes me a bit worried since this is the first time my eye pressure has been above 21 mmHg; previously, it was at most 20 mmHg.
I would like to know if it is necessary for me to follow up at a major hospital, or if I can just go to a clinic for a re-evaluation? Additionally, I found conflicting information online: some people say that an intraocular pressure over 20 mmHg is considered high, while others say it is over 21 mmHg.
I'm not sure which is correct.

Liu Xiansheng, 30~39 year old female. Ask Date: 2022/08/29

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Liu: There is no need to be overly fixated on the numbers 20 and 21; these are merely indicators representing the threshold close to the average normal intraocular pressure.
This serves as a warning sign that there is a possibility of developing glaucoma.
However, it is also important to consider corneal thickness, as well as the condition of the optic nerve and visual fields.
A comprehensive assessment of these examination results is necessary to determine the likelihood of glaucoma.
Therefore, whether you go to a large hospital or a clinic, regular follow-up is all that is needed.

Reply Date: 2022/08/29

More Info

When it comes to understanding eye pressure and the potential risk of glaucoma, it's essential to consider several factors, including the measurements you've received, your overall eye health, and any symptoms you may be experiencing.
Firstly, the eye pressure readings you've mentioned—17 mmHg in the left eye and 21 mmHg in the right eye—are indeed significant. Generally, normal intraocular pressure (IOP) ranges from 10 to 21 mmHg. While a reading of 21 mmHg is at the upper limit of normal, it is crucial to understand that eye pressure alone does not diagnose glaucoma. Glaucoma is a complex condition that involves damage to the optic nerve, often associated with elevated eye pressure, but not exclusively so.
The fact that your previous readings were mostly below 20 mmHg and that you have now crossed the 21 mmHg threshold may warrant further investigation. It is not uncommon for eye pressure to fluctuate, and factors such as stress, anxiety, and even the method of measurement (like the air puff test you mentioned) can influence the readings. If you feel uncomfortable with the results or if you have a family history of glaucoma, it would be prudent to seek a follow-up examination, preferably at a larger medical facility where more comprehensive testing can be conducted.

Regarding the definitions of high eye pressure, there is some variability in the literature. Generally, pressures above 21 mmHg are often considered elevated, but some practitioners may use a threshold of 20 mmHg. The important takeaway is that while elevated IOP is a risk factor for glaucoma, it is not the sole determinant. Other factors, such as the appearance of the optic nerve (optic disc), visual field tests, and the presence of any symptoms, are also critical in making a diagnosis.

If you are experiencing any symptoms such as vision changes, headaches, or discomfort, these should be communicated to your eye care provider. Additionally, if you have a family history of glaucoma or other risk factors (like high myopia, which you mentioned in previous queries), regular monitoring is essential.
In terms of next steps, you have a couple of options. If you feel confident in the assessment from your current provider, you could schedule a follow-up appointment for monitoring. However, if you have lingering concerns, seeking a second opinion from a specialized ophthalmologist or a glaucoma specialist would be beneficial. They can perform a comprehensive evaluation, including visual field tests and optical coherence tomography (OCT), to assess the health of your optic nerve and determine if there is any damage indicative of glaucoma.

In summary, while your eye pressure readings are concerning, they do not automatically indicate glaucoma. It is essential to consider the complete clinical picture, including other diagnostic tests and your symptoms. Regular follow-ups and open communication with your eye care provider will help ensure that any potential issues are addressed promptly and effectively. Remember, early detection and management are key in preserving your vision and eye health.

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