Eye Pressure, Visual Field Tests, and Corneal Thickness Measurements

Q: Eye Pressure, Visual Field Tests, and Corneal Thickness Measurements

Hello： Based on your description, there has been some fluctuation in your intraocular pressure (IOP) between the two examinations, with a slight increase noted. <br>It is possible for IOP to vary in the short term, and sometimes emotional stress or tension can lead to elevated pr

Visual field test, intraocular pressure, corneal thickness?

Hello, Doctor.
I previously visited the hospital due to red eyes, and during my first visit, my intraocular pressure was measured at 22.23, which was considered normal and possibly due to stress.
However, during my follow-up appointment today, my intraocular pressure was higher at 25.26, with a two-week interval between visits.
I was scheduled for a visual field test next time.
Additionally, both the first and second visits included measurements of corneal thickness, but they could not be obtained.
I would like to ask if this is normal.
Each time my intraocular pressure is measured, air is puffed into my eyes, which makes me very uncomfortable, and I cannot open my eyes wide.
Could this have any impact? Also, what could be the reasons for not being able to measure corneal thickness? Thank you.

Niming, 20~29 year old female. Ask Date: 2023/09/14

Dr. Gao Pilin reply Ophthalmology

Hello: Based on your description, there has been some fluctuation in your intraocular pressure (IOP) between the two examinations, with a slight increase noted.
It is possible for IOP to vary in the short term, and sometimes emotional stress or tension can lead to elevated pressure.
However, to ensure your eye health, the physician has arranged for further visual field testing, which is the appropriate course of action to rule out any issues with the retina or optic nerve.
Regarding the discomfort experienced during the IOP measurement, this is a fairly normal reaction.
The air puff tonometer used during the examination may cause sensations of dryness, burning, or mild discomfort in the eyes.
This feeling is typically temporary and will not cause any lasting effects on your eyes.
To make the examination easier, you can try to maintain steady breathing, keep your eyes relaxed, and inform the physician if you feel uncomfortable; they can adjust the testing method as needed.
As for the inability to measure corneal thickness, this may sometimes be due to the unique characteristics of the corneal structure or limitations of the measuring instrument.
Generally, measuring corneal thickness is important for accurately interpreting IOP values, as thickness can influence the assessment of pressure.
If corneal thickness cannot be measured, the physician may consider alternative methods to evaluate your IOP and overall eye health.

Reply Date: 2023/09/14

More Info

Understanding eye pressure, visual field tests, and corneal thickness measurements is crucial for maintaining eye health, especially when there are concerns about conditions like glaucoma. Your experience of fluctuating eye pressure readings and difficulties with corneal thickness measurements raises several important points that merit discussion.

Firstly, it’s important to recognize that eye pressure, measured in millimeters of mercury (mmHg), can vary due to a variety of factors, including stress and anxiety. As you noted, your initial eye pressure readings were 22 and 23 mmHg, which are on the higher end of the normal range (typically considered to be between 10 and 21 mmHg). The subsequent readings of 25 and 26 mmHg indicate a potential increase, which could be influenced by your emotional state during the examination. Anxiety can indeed lead to temporary spikes in eye pressure, and this is a common phenomenon. However, a single elevated reading does not automatically indicate glaucoma; a comprehensive evaluation is necessary.

The visual field test is an essential component of glaucoma diagnosis. It assesses the peripheral vision and can reveal any loss of vision that may not be apparent during a standard eye exam. If your eye pressure remains elevated, the visual field test will help determine if there is any corresponding damage to the optic nerve, which is critical for diagnosing glaucoma. It’s good that your doctor has scheduled this test, as it will provide more information about your eye health.

Regarding the discomfort you experience during eye pressure measurements, particularly with the air puff test (non-contact tonometry), this is a common reaction. Many patients find the sensation uncomfortable, but it is generally a safe procedure. If you find it particularly distressing, communicate this to your healthcare provider; they may be able to use alternative methods for measuring eye pressure, such as applanation tonometry, which involves a small probe that gently touches the surface of the eye after numbing drops are applied.

As for the corneal thickness measurements, it’s unusual for this to be difficult to obtain. Corneal thickness is an important factor in assessing eye pressure accurately, as thicker corneas can lead to higher pressure readings. If the measurements were not successful, it could be due to several factors, including the technique used, the condition of your cornea, or even the equipment itself. If your cornea is particularly irregular or if there is significant dryness or discomfort, this may affect the ability to obtain a reading. Your eye care provider may consider alternative methods or repeat the measurement at a later date when you are more comfortable.

In summary, while your fluctuating eye pressure readings and difficulties with corneal thickness measurements are concerning, they are not uncommon. It’s essential to follow up with the visual field test and maintain open communication with your eye care provider about your anxiety and discomfort during examinations. They can provide support and possibly alternative methods for testing that may be more comfortable for you. Regular monitoring and comprehensive assessments will help ensure that any potential issues are identified and managed appropriately.

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