Eye Pressure Medications and Managing Ocular Discomfort - Ophthalmology

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Could you please provide more details regarding eye pressure-lowering eye drops and the issue of elevated intraocular pressure?


Hello, Doctor.
Over the past two to three years, I have been having my eyes checked at a local clinic, where it was found that my intraocular pressure (IOP) is consistently between 19 and 23 mmHg in both eyes.
I also underwent visual field testing and optic nerve examination at the end of last year, and the doctor confirmed that everything is normal and that I do not have glaucoma, advising me to monitor my IOP regularly.
Last Sunday, after swimming, I experienced persistent discomfort in my eyes, including dryness, a burning sensation, swelling, and a feeling of heaviness and fatigue in my eyelids.
I went to the clinic yesterday evening for a check-up, where my IOP was measured at 21 mmHg in the left eye and 23 mmHg in the right eye.
Two weeks ago, during a routine follow-up, my IOP was measured at 20 mmHg in both eyes.
The doctor prescribed Safrin eye drops and a pressure-lowering eye drop (for lowering IOP).
I have the following questions:
1.
The doctor advised me to use the pressure-lowering eye drops when I feel a swelling sensation in my eyes.
I would like to know if using this eye drop will definitely lower my IOP, and if I stop using it, will my IOP return to its previous levels? I haven't used it yet because I'm concerned that I might have to use it continuously.
Also, if I use it for a month and my IOP decreases, can my eyes maintain the lower pressure on their own without further treatment?
2.
The doctor checks my optic nerve using a small lens and a light beam while asking me to move my eyes up, down, left, and right.
Is this method accurate for assessing the optic nerve, or is an OCT (Optical Coherence Tomography) scan necessary for a more accurate evaluation?
3.
The doctor mentioned that my discomfort might not be directly related to my IOP and speculated that it could be due to the pool water being dirty, which may have irritated my sensitive eyes.
Is it correct to say that the Safrin eye drops are intended for antibacterial and anti-inflammatory purposes?
4.
My IOP values have been consistently in this range for many years, and each examination has shown normal results.
Are there any natural ways to help lower my IOP, such as avoiding coffee, reducing late-night activities, or limiting screen time? Besides lifestyle changes, are medications the only option?
Thank you very much for your assistance!

john, 30~39 year old female. Ask Date: 2023/08/09

Dr. Gao Pilin reply Ophthalmology


Hello: 1.
Eye pressure-lowering eye drops (such as Timolol eye drops) typically need to be used continuously to effectively reduce intraocular pressure.
Once usage is stopped, the eye pressure may return to previous levels.
Your physician may recommend the duration of use based on your condition and needs.
If the eye pressure decreases and remains stable, your physician may adjust the treatment plan.
2.
Examining the optic nerve through a small lens and light beam is a common examination method, but for a more detailed assessment, such as measuring the thickness of the retinal nerve fiber layer, Optical Coherence Tomography (OCT) is a more accurate and detailed examination method.
The choice of optic nerve examination depends on the physician's judgment and the patient's condition.
3.
Saffron eye drops may have some anti-inflammatory and discomfort-relieving effects.
Exposure to pool water may cause discomfort in the eyes.
4.
In addition to medication, improving lifestyle habits may also help maintain intraocular pressure within the normal range.
This includes maintaining a proper diet, engaging in moderate exercise, avoiding prolonged use of digital devices (especially computers and smartphones), and moderating caffeine intake.
However, for individuals with long-term stable intraocular pressure, changes in lifestyle habits may only have a minor impact on eye pressure.

Reply Date: 2023/08/09

More Info


Hello! Thank you for your detailed questions regarding eye pressure medications and managing ocular discomfort. It sounds like you have been proactive about your eye health, which is commendable. Let’s address your concerns one by one.

1. Regarding the use of the eye pressure-lowering medication (適眼眼藥水): When you start using a medication to lower eye pressure, it is typically necessary to continue using it as prescribed to maintain the desired effect. If you stop using the medication, your eye pressure may return to its previous levels. The medication works by reducing the production of aqueous humor or increasing its outflow, thus lowering intraocular pressure (IOP). If you use it consistently for a month and your eye pressure decreases, it does not guarantee that your eye pressure will remain low without continued use of the medication. Regular follow-up with your eye care provider is essential to monitor your eye pressure and adjust your treatment as necessary.

2. On the method of checking the optic nerve: The method your doctor used, which involves a small lens and a light beam, is a common technique for assessing the optic nerve head. However, while this method can provide valuable information, it may not be as comprehensive as Optical Coherence Tomography (OCT). OCT is a non-invasive imaging test that provides cross-sectional images of the retina and can give a more detailed view of the optic nerve and retinal layers. If there are concerns about the optic nerve, your doctor may recommend an OCT for a more thorough evaluation.

3. Regarding your discomfort after swimming: Your doctor’s suggestion that your discomfort may be related to swimming pool water is plausible. Chlorinated water and other chemicals can irritate sensitive eyes, leading to symptoms like dryness, redness, and a feeling of heaviness. The prescription of 沙芬眼藥水 (which likely has antibacterial or anti-inflammatory properties) is intended to help alleviate any irritation or infection that may have resulted from exposure to the pool water. It’s essential to follow your doctor’s advice and use the medication as directed.

4. Natural ways to manage eye pressure: While lifestyle changes can positively impact overall eye health, they may not significantly lower eye pressure for everyone. However, some general recommendations include:
- Diet: Incorporating foods rich in antioxidants (like leafy greens, fish, and fruits) can support eye health.

- Hydration: Staying well-hydrated is crucial, but avoid excessive fluid intake in a short period, as it can temporarily raise eye pressure.

- Regular Exercise: Moderate physical activity can help lower eye pressure.

- Sleep: Ensure you get adequate sleep, as fatigue can exacerbate eye discomfort.

- Limit Caffeine: Some studies suggest that high caffeine intake may increase eye pressure, so moderation is advisable.

- Screen Time: Reducing prolonged screen time and taking regular breaks can help alleviate eye strain and discomfort.

In conclusion, while medications are often necessary to manage eye pressure effectively, adopting a healthy lifestyle can complement your treatment. Always consult with your eye care provider before making any changes to your medication or treatment plan. Regular check-ups and open communication with your doctor are key to maintaining your eye health. If your symptoms persist or worsen, don’t hesitate to seek further evaluation. Thank you for your questions, and I hope this information helps you manage your ocular health effectively!

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