High Eye Pressure and Its Connection to Visual Disturbances - Ophthalmology

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Elevated intraocular pressure with halos?


Hello, doctor.
Last month, I noticed that I have persistent halos around lights, both day and night.
I went to the medical school, and the doctor said my intraocular pressure exceeded the critical point but did not specify the exact value.
They scheduled me for a visual field test and a CT scan, among six other tests, in a month.
They only prescribed a bottle of chloramphenicol.
Recently, I've been experiencing some headaches and a feeling of pressure in my eyes, so I visited a nearby ophthalmology clinic.
The intraocular pressure was 19 mmHg in my right eye and 21 mmHg in my left eye.
The ophthalmologist mentioned that the pressure is slightly elevated, and while the left eye is okay, the right eye shows a significant abnormal indentation.
They concluded that, regardless of the situation, I need to lower my intraocular pressure to protect my optic nerve, so they prescribed timolol maleate for me to start using.
Doctor, should I start using the drops now, or wait for the tests in a month, or should I go back to see the same doctor at the medical school?

Xiao Neng, 20~29 year old female. Ask Date: 2016/02/15

Dr. Gao Pilin reply Ophthalmology


Hello, Xiao Neng: A visual field test is necessary to assess whether there is any optic nerve damage.
However, it is advisable to lower the intraocular pressure slightly; I recommend starting medication and following your physician's instructions for examination.
The ophthalmology department at Puzi Hospital in Taiwan is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM.
I hope to have the opportunity to serve you.
Gao Pi-Lin.

Reply Date: 2016/02/15

More Info


High eye pressure, also known as ocular hypertension, can lead to various visual disturbances and symptoms, including halos around lights (often referred to as "rainbow vision"), headaches, and a feeling of pressure or swelling in the eyes. Your recent experiences with visual disturbances, particularly the persistent halos you see regardless of the time of day, warrant careful consideration and prompt action.

First, it’s important to understand that elevated eye pressure can be a risk factor for glaucoma, a condition that can lead to irreversible vision loss if not managed appropriately. The fact that your eye pressure readings were 19 mmHg in your right eye and 21 mmHg in your left eye indicates that you are at the upper limit of what is considered normal (typically, normal intraocular pressure ranges from 10 to 21 mmHg). The presence of a significant "cupping" or abnormal indentation in the optic nerve head, particularly in your right eye, is concerning and suggests that there may be damage to the optic nerve, which could be related to elevated eye pressure.

Regarding your current treatment options, the prescription of timolol maleate, a beta-blocker eye drop, is a common first-line treatment for lowering intraocular pressure. It works by reducing the production of aqueous humor, the fluid in the eye, thereby decreasing eye pressure. Given that your eye pressure is already elevated and you are experiencing symptoms such as headaches and a feeling of pressure in your eyes, it is advisable to start using the prescribed eye drops as directed. Delaying treatment until your follow-up appointment could potentially allow for further progression of any underlying condition, especially if you are already experiencing symptoms.

In terms of your upcoming tests, including visual field testing and optical coherence tomography (OCT), these will provide valuable information about the health of your optic nerve and the extent of any damage that may have occurred. It is crucial to have these assessments done, as they will guide your treatment plan moving forward. However, starting the eye drops now will help to manage your eye pressure in the interim and protect your optic nerve from further damage.

If you have concerns about the treatment plan or if you experience any worsening of symptoms, it would be prudent to reach out to your ophthalmologist at the medical school for further guidance. They can provide you with a comprehensive evaluation and adjust your treatment plan as necessary based on the results of your upcoming tests.

In summary, it is important to take your symptoms seriously and to begin treatment with the prescribed eye drops to manage your eye pressure effectively. Regular follow-up appointments and tests will be essential in monitoring your condition and ensuring that your vision remains protected. If you have any additional questions or concerns, do not hesitate to consult with your healthcare provider. Your eye health is paramount, and proactive management is key to preventing potential complications.

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