High Eye Pressure: Is It Glaucoma and Should You Consider Surgery?

Q: High Eye Pressure: Is It Glaucoma and Should You Consider Surgery?

Hello： Based on your description, your intraocular pressure has been consistently elevated, and there has been no significant improvement with medication. <br>This may be a symptom of glaucoma. <br>Glaucoma is an eye condition typically associated with increased intraocular press

Regarding elevated intraocular pressure?

Hello Dr.
Gao, I am the one who asked about seeing rainbows and white fog in my eyes last month #205485.
Initially, my intraocular pressure was within the normal range, but during my follow-up visit in early March, it surprisingly measured 44.
The doctor prescribed three medications: Shulutong eye drops, Kangbigen, and Shuer Tan, to be administered three times a day for four weeks.
During my visit yesterday, my intraocular pressure was still 48, which puzzled the doctor.
He asked if I had made any lifestyle changes, but I haven't changed anything in my routine.
Currently, I have been prescribed oral medication to monitor for a week, and if the pressure does not decrease, the doctor is considering hospitalization for surgery.
I would like to ask Dr.
Gao: 1.
Is my condition glaucoma? 2.
Would you also recommend surgery? Thank you.

Niming, 20~29 year old female. Ask Date: 2024/03/27

Dr. Gao Pilin reply Ophthalmology

Hello: Based on your description, your intraocular pressure has been consistently elevated, and there has been no significant improvement with medication.
This may be a symptom of glaucoma.
Glaucoma is an eye condition typically associated with increased intraocular pressure, which can lead to optic nerve damage and loss of vision.
As for the recommendation for surgery, it is usually considered when medication is ineffective or the condition is severe.
Therefore, your physician suggests monitoring for another week, and if the pressure does not decrease, hospitalization for surgery may be necessary.
The advice given by your attending physician is correct; if medication cannot control the pressure, early surgical intervention is required to prevent further permanent damage to the optic nerve.

Reply Date: 2024/03/27

More Info

High eye pressure, also known as ocular hypertension, can be a significant concern, especially for individuals with a history of high myopia or other risk factors for glaucoma. In your case, with eye pressure readings of 44 and 48 mmHg, it is crucial to understand the implications of these numbers and the potential need for surgical intervention.

1. Is This Glaucoma?
Based on the eye pressure readings you provided, it is possible that you are experiencing a form of glaucoma, particularly if there are accompanying symptoms such as seeing halos around lights or blurred vision. Glaucoma is characterized by damage to the optic nerve, often due to elevated intraocular pressure (IOP). While not everyone with high eye pressure will develop glaucoma, your readings are significantly above the normal range (typically considered to be 10-21 mmHg). The fact that your eye pressure has increased to such levels, especially after previously being within normal limits, warrants a thorough evaluation by your ophthalmologist. They will likely perform additional tests, such as visual field tests and optical coherence tomography (OCT), to assess the health of your optic nerve and determine if there is any damage indicative of glaucoma.

2. Should You Consider Surgery?
The decision to proceed with surgery typically depends on several factors, including the severity of the eye pressure, the effectiveness of current treatments, and the overall health of your optic nerve. If your eye pressure remains elevated despite the use of prescribed medications (like the ones you mentioned: pilocarpine, brimonidine, and dorzolamide), and if there are signs of optic nerve damage, your doctor may recommend surgical options. These could include procedures such as trabeculectomy or the implantation of drainage devices, which aim to lower eye pressure by improving fluid drainage from the eye.

It is essential to follow your doctor's advice closely. If your eye pressure does not decrease after a week of oral medication, hospitalization for further treatment may be necessary. This could involve more intensive medical management or surgical intervention to prevent permanent damage to your vision.

Additional Considerations:
- Monitoring and Follow-Up: Regular follow-up appointments are crucial to monitor your eye pressure and optic nerve health. Your doctor may adjust your treatment plan based on your response to medications and any changes in your condition.

- Lifestyle Factors: While anxiety can temporarily elevate eye pressure during measurements, persistent high readings are typically due to underlying ocular conditions. Maintaining a healthy lifestyle, including a balanced diet and regular exercise, can support overall eye health.

- Education and Awareness: Understanding your condition is vital. Ask your ophthalmologist about the specifics of your diagnosis, treatment options, and what you can do to manage your eye health effectively.

In conclusion, given your current eye pressure readings and the potential implications for glaucoma, it is essential to take your symptoms seriously. Engage in open communication with your ophthalmologist, adhere to their recommendations, and consider all treatment options available to protect your vision.

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