Managing Anxiety and Eye Pressure: Exploring Medication Options

Psychiatric medications

Hello Doctor, I previously experienced anxiety for about a year, which led to symptoms similar to autonomic nervous system dysfunction, including frequent urination and urgency.
The doctor prescribed me FLUOXETINE 20mg to take monthly for a year.
After stopping the medication for six months, I have returned to normal.
The doctor left me with some medication for emergencies, advising me to take it if I experience any issues.

On May 5th of this year, during a military re-examination for ophthalmology, no results were provided, and no specific problems were mentioned.
On May 6th, I visited an ophthalmology clinic, which also reported that everything was normal.
However, on May 20th, due to psychological factors, I noticed floaters and consulted another clinic, where they mentioned that my intraocular pressure was high and prescribed eye drops to lower it, with a follow-up appointment in two weeks.

Since then, I have been feeling quite anxious because the elevated eye pressure seems to pose a risk for glaucoma.
I am considering going to a major hospital for an examination on May 24, 2023, and I am contemplating whether I should take the anti-anxiety medication.
Does this medication contain steroids that could raise intraocular pressure?

You, 20~29 year old female. Ask Date: 2023/05/22

Dr. Qiu Junda reply Psychiatry

Hello.
This medication does not contain steroids.
If you are experiencing anxiety or other physical and mental distress, it is recommended that you have regular follow-up appointments and adhere to the prescribed treatment plan, including medication, to facilitate improvement.

Reply Date: 2023/05/22

More Info

Managing anxiety and eye pressure is a multifaceted issue that requires careful consideration of both psychological and physiological factors. Your experience with anxiety, particularly in relation to your eye health, is not uncommon. Anxiety can indeed exacerbate physical symptoms, including those related to eye pressure and overall ocular health.

First, let's address your concerns about the medication you were prescribed, Fluoxetine. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat anxiety and depression. Importantly, it does not contain steroids, which are known to potentially elevate intraocular pressure (IOP). Therefore, you can take Fluoxetine without worrying about it contributing to increased eye pressure or the risk of glaucoma. However, it is essential to monitor your anxiety levels, as heightened anxiety can lead to physiological responses that may temporarily increase your eye pressure during examinations.

Regarding your eye health, it is crucial to understand that elevated eye pressure does not automatically indicate glaucoma. While high IOP is a significant risk factor for glaucoma, the diagnosis involves a comprehensive evaluation, including visual field tests and examination of the optic nerve. Your previous assessments indicating normal eye health are reassuring, but it is wise to remain vigilant, especially if you have a family history of eye conditions or if you experience new symptoms.

If you are experiencing anxiety related to your eye pressure, it may be beneficial to consult with both an ophthalmologist and a mental health professional. The ophthalmologist can provide a thorough examination to rule out any underlying conditions and to monitor your eye pressure over time. Meanwhile, a mental health professional can help you develop coping strategies for managing anxiety, which may include therapy or medication adjustments.

In terms of medication options for anxiety, if you find that your anxiety is significantly impacting your daily life or your ability to manage your eye health, discussing alternative treatments with your healthcare provider is advisable. There are various classes of medications available for anxiety, including benzodiazepines, which can provide short-term relief but may have side effects, including sedation and potential dependency. Non-benzodiazepine anxiolytics or therapy options, such as cognitive-behavioral therapy (CBT), may also be effective without the same risks.

Additionally, lifestyle modifications can play a significant role in managing both anxiety and eye pressure. Regular exercise, a balanced diet, adequate sleep, and mindfulness practices such as meditation or yoga can help reduce anxiety levels and improve overall well-being. Staying hydrated and managing screen time can also contribute positively to eye health.

In conclusion, while your concerns about eye pressure and anxiety are valid, it is essential to approach them holistically. Continue to monitor your eye health with regular check-ups, and consider discussing your anxiety management strategies with your healthcare provider. By addressing both aspects, you can work towards achieving a balanced state of health that supports both your mental and ocular well-being.

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