Eye Pressure Issues: Symptoms, Treatments, and Tests

Q: Eye Pressure Issues: Symptoms, Treatments, and Tests

Hello： 1. <br>If dilation is not performed and peripheral vision can still be assessed, non-dilated ultra-widefield fundus photography can be used, although this equipment may not be available everywhere. <br>Therefore, dilation is the simplest method. <br>2. <br>Elevated intraoc

Eye problems

Hello Doctor: On around October 28, I went to the clinic for a fundus examination but was informed that my left eye had an intraocular pressure of 22 and my right eye had 19, making it impossible to perform the fundus examination.
I was told that using a dilating agent could potentially trigger acute glaucoma, and I was prescribed an eye drop called Metrolan.
I was advised to return for a check-up in two weeks.
After returning home, my family mentioned that this medication could induce asthma (I have asthma), and they provided me with another eye drop called Shulutong, stating that it would not trigger asthma and advised me to use this instead.
After using it for about five days, I gradually forgot about it, and by the time I remembered, two weeks had already passed without using any medication.
My family said I need to go for another fundus examination around November 28.
Should I start using Shulutong eye drops again immediately? Thank you, Doctor.

1.
Is there a method to perform a complete retinal examination without using a dilating agent? I heard from the doctor that fundus photography can only capture the central area and not the edges.

2.
Are there tests available to determine the cause of elevated intraocular pressure?
3.
When I am in a car, I feel a slight pressure in my eyes; is this a sign of elevated intraocular pressure?
4.
Regarding headaches caused by high intraocular pressure, where would the pain typically be located? How can I reduce the intraocular pressure in this case?
5.
Is there a test available to assess the liquefaction of the vitreous body?

Shuì bù hǎo de rén, 20~29 year old female. Ask Date: 2022/11/20

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
If dilation is not performed and peripheral vision can still be assessed, non-dilated ultra-widefield fundus photography can be used, although this equipment may not be available everywhere.
Therefore, dilation is the simplest method.
2.
Elevated intraocular pressure is due to an imbalance between the production and drainage of fluid within the eye, often caused by a malfunction in the eye's drainage system.
When the drainage system is not functioning properly, fluid continues to accumulate without being expelled, leading to excessive fluid buildup and increased intraocular pressure.
3.
Typically, this is not the case; significant elevation in intraocular pressure is usually required to experience a pronounced sensation of pressure.
4.
Currently, there is no such examination available.

Reply Date: 2022/11/20

More Info

Hello! Thank you for your questions regarding eye pressure issues, symptoms, treatments, and tests. It’s important to understand that eye pressure, or intraocular pressure (IOP), is a critical factor in maintaining eye health, particularly in relation to conditions like glaucoma. Let’s address your questions one by one.

1. Alternative Methods for Fundus Examination Without Mydriatics: While mydriatic eye drops (like the one you mentioned, Metrolan) are commonly used to dilate the pupils for a thorough examination of the retina, there are alternative methods available. Optical coherence tomography (OCT) is one such method that provides detailed images of the retina without the need for dilation. Additionally, fundus photography can also be performed without dilation, although it may not provide as comprehensive a view of the peripheral retina. Discuss these options with your eye care provider to see if they are suitable for your situation.

2. Tests to Determine Causes of Elevated Eye Pressure: To identify the underlying causes of elevated IOP, several tests can be conducted. These include pachymetry, which measures corneal thickness, as thicker corneas can lead to falsely elevated IOP readings. Gonioscopy is another test that examines the drainage angle of the eye, which can reveal whether the angle is open or closed, a critical factor in glaucoma. Additionally, visual field testing can assess any functional loss related to elevated IOP.

3. Feeling of Pressure in the Eyes: Experiencing a sensation of pressure or fullness in the eyes can be associated with elevated IOP, but it is not definitive. Other factors, such as eye strain from prolonged screen time or dry eyes, can also contribute to this sensation. If this feeling persists or worsens, it’s advisable to consult your eye care professional for further evaluation.

4. Headaches Related to High Eye Pressure: If elevated IOP is causing headaches, the pain is often described as a dull ache around the eyes or forehead. It may also be accompanied by other symptoms such as blurred vision or halos around lights. To manage elevated IOP and associated headaches, it is crucial to follow your doctor's recommendations regarding medication. If you experience severe headaches or other alarming symptoms, seek immediate medical attention.

5. Checking for Vitreous Liquefaction: There are tests that can assess the condition of the vitreous humor, such as a comprehensive dilated eye exam where the doctor can observe the vitreous for any abnormalities. Additionally, OCT can provide insights into the vitreous and its attachment to the retina. If you have concerns about vitreous liquefaction or other related issues, discuss these with your eye care provider.

In summary, it is essential to monitor your eye health closely, especially with a history of elevated IOP and asthma. If you have missed doses of your prescribed eye drops, it is advisable to resume them as soon as possible and consult your eye doctor about your upcoming appointment. They can provide guidance on the best course of action and any necessary adjustments to your treatment plan. Regular follow-ups and open communication with your healthcare provider are key to managing eye pressure effectively and maintaining overall eye health.

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