Eye Pressure, Brain Pressure, and Vision Loss: A Patient's Journey

Intraocular pressure, intracranial pressure, and visual field loss?

Hello, doctor.
Since 2021, I have been regularly monitored at a hospital in central Taiwan due to elevated intraocular pressure.
During this period, my eye pressure was normal for a while.
After returning to Taipei in March 2023, I continued to have my eye pressure monitored at Taipei Medical University, where it fluctuated between high and low.
Upon examination, the doctor informed me that there were no abnormalities in the optic nerve, but my visual field test showed partial visual field loss on the left side when looking straight ahead, although the doctor did not raise any specific concerns.
In December 2023, I sought follow-up care at a nearby ophthalmology clinic with similar diagnostic equipment, where my intraocular pressure occasionally spiked to around 30 mmHg.
The doctor again confirmed that there were no abnormalities in the optic nerve or retina, but I had tried various medications to lower the eye pressure with unsatisfactory results.
In July, I experienced significant disruptions in my sleep schedule, with irregular day-night cycles and reduced physical activity.
In mid-January 2024, I noticed that the previously observed visual field loss on the left side had developed into a horizontal strip that I could not see.
My intraocular pressure even exceeded 30 mmHg.
By the end of the month, I began experiencing left-sided temporal headaches, left orbital pain, discomfort in the left posterior head (at the Fengchi acupoint), occasional brief dizziness, and nausea (though I did not actually vomit).
Despite sleeping nearly 12 hours, I still felt fatigued.
The pain, dizziness, and nausea came and went.
During my follow-up for eye pressure, I informed the clinic about my symptoms, and they conducted a series of eye examinations, which still indicated high intraocular pressure, but no abnormalities in the optic nerve or retina.
Recently, I consulted with Dr.
Lyu Dawen, a glaucoma specialist, and provided my previous medical records for reference.
He suggested that my symptoms do not appear to be indicative of glaucoma and that I might have "elevated intracranial pressure," recommending that I see a neurologist.
On the same day, I also consulted a neurologist, informing them of my symptoms and current situation (visual field loss, high intraocular pressure, and feelings of dizziness and nausea).
After the consultation, the doctor arranged for me to undergo an MRI and blood tests related to rheumatology and immunology (the MRI is scheduled for the end of March 2024).
I do not have hypertension or diabetes, and my BMI is 21, but I have previously experienced autonomic nervous system dysregulation and panic disorder.
At the end of 2023, my basic blood and urine test results were all within normal ranges.
I would like to understand the following:
1.
After researching "elevated intracranial pressure," I found that it is often associated with serious and dangerous conditions.
During the waiting period for the MRI to confirm any lesions, am I at risk of life-threatening conditions? (I found that causes of elevated intracranial pressure include cerebral hemorrhage, hydrocephalus, and tumors.)
2.
What precautions or contraindications should I be aware of during this waiting period? Would exercise be beneficial?
3.
Will this visual field loss recover in the future, and is it considered temporary visual field loss?
Thank you very much for your consultation and response.

Mr. Huang, 30~39 year old female. Ask Date: 2024/01/30

Dr. Jiang Junyi reply Neurology

Dear Mr.
Huang,
You mentioned that "high intracranial pressure" is often associated with significant and dangerous conditions.
It is important to distinguish between acute and chronic increases in intracranial pressure.
In cases of acute intracranial hypertension, patients may experience symptoms such as elevated blood pressure, bradycardia, and slowed respiration.
Additionally, typical symptoms include headaches, vomiting, and papilledema leading to blurred vision.
Patients with acute intracranial pressure elevation often exhibit altered consciousness.
Your symptoms should help rule out acute issues.
However, since there is a possibility of increased intracranial pressure, it is advisable to avoid holding your breath and to maintain regular bowel movements, avoiding straining during defecation.
If your symptoms persist without improvement, I recommend returning for an earlier follow-up.
If you experience new neurological symptoms such as severe headaches or vomiting, please go to the emergency room.
Thank you for your inquiry.
If you have any related questions, feel free to discuss them further.
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi
Department of Neurology
Taoyuan Hospital

Reply Date: 2024/01/30

More Info

Understanding the complexities of eye pressure, brain pressure, and vision loss is crucial for patients experiencing symptoms like yours. Your journey reflects a common concern among individuals dealing with high eye pressure and potential neurological issues. Let’s address your questions and provide some insights based on medical knowledge.

1. Life Threats from High Brain Pressure: It’s understandable to be concerned about high brain pressure (intracranial pressure). While elevated intracranial pressure can be serious, the symptoms you describe—such as headaches, nausea, and visual disturbances—do not necessarily indicate an immediate life threat. Acute increases in intracranial pressure can lead to severe complications, but your symptoms seem to suggest a more chronic issue, especially since you have been monitored and evaluated by specialists. It’s essential to follow through with the MRI and any additional tests your neurologist recommends to rule out serious conditions like tumors or hydrocephalus. Until then, while it’s wise to remain vigilant, there’s no need for panic.
2. Precautions During the Waiting Period: During this waiting period for your MRI, it’s important to manage your symptoms and maintain a healthy lifestyle. Avoid activities that could exacerbate your symptoms, such as heavy lifting or straining, which could increase intracranial pressure. Gentle exercises like walking or yoga can be beneficial, but listen to your body and avoid anything that causes discomfort. Staying hydrated and maintaining a balanced diet can also support your overall health. If you experience any new or worsening symptoms, such as severe headaches or changes in consciousness, seek immediate medical attention.

3. Potential for Recovery of Vision: Regarding your visual field loss, it’s difficult to predict whether this will be temporary or permanent without further evaluation. Vision loss can sometimes be reversible, especially if the underlying cause is addressed promptly. However, if the visual field loss is due to sustained high eye pressure or other chronic conditions, it may not fully recover. Regular follow-ups with your ophthalmologist and neurologist will be crucial in monitoring your condition and determining the best course of action.

In summary, while the concerns surrounding high eye pressure and potential brain pressure are valid, it’s important to approach them with a balanced perspective. Continue to engage with your healthcare providers, adhere to their recommendations, and keep track of your symptoms. Mental health is also a critical component of your overall well-being; consider seeking support from mental health professionals if anxiety becomes overwhelming. Remember, you are not alone in this journey, and there are resources available to help you navigate these challenges.

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