The term ocular hypertension usually refers to any situation in which the pressure inside the eye, called intraocular pressure, is higher than normal. Eye pressure is measured in millimeters of mercury (mm Hg). Normal eye pressure ranges from 10-21 mm Hg. Ocular hypertension is an eye pressure of greater than 21 mm Hg. Show
Although its definition has evolved through the years, ocular hypertension is commonly defined as a condition with the following criteria:
Ocular hypertension should not be considered a disease by itself. Instead, ocular hypertension is a term that is used to describe individuals who should be observed more closely than the general population for the onset of glaucoma. For this reason, another term to refer to a person with ocular hypertension is "glaucoma suspect," or someone whom the eye doctor is concerned may have or may develop glaucoma because of elevated pressure inside the eyes. An eye exam may show a glaucoma-damaged optic nerve. As mentioned above, increased intraocular pressure can result from other eye conditions. However, within this article, ocular hypertension primarily refers to increased intraocular pressure without any optic nerve damage or vision loss. Glaucoma is diagnosed when characteristic optic nerve and vision changes occur; typically with elevated eye pressure but occasionally with normal pressure. As of the year 2022, an estimated 3 million people in the United States had glaucoma and more than 120,000 are legally blind because of this disease. These statistics alone emphasize the need to identify and closely monitor people who are at risk of developing glaucoma, particularly those with ocular hypertension. Some studies have found that the average intraocular pressure in African-Americans is higher than in whites, while other studies have found no difference. Although some studies have reported a significantly higher average intraocular pressure in women than in men, other studies have not shown any difference between men and women. Intraocular pressure slowly rises with increasing age, just as glaucoma becomes more prevalent as you get older.
Ocular Hypertension CausesElevated intraocular pressure is a concern in people with ocular hypertension because it is one of the main risk factors for glaucoma. Most people with ocular hypertension do not experience any symptoms. For this reason, regular eye examinations with an eye doctor are very important to rule out any damage to the optic nerve from the high pressure. An eye doctor performs tests to measure intraocular pressure as well as to rule out early primary open-angle glaucoma or secondary causes of glaucoma. These tests are explained below. If your eye doctor prescribes medicines (see Medical Treatment and Medications) to help lower the pressure inside your eye, properly applying the medication and complying with your doctor’s instructions are very important. Not doing so could result in a further increase in intraocular pressure that can lead to optic nerve damage and permanent vision loss (i.e, glaucoma). The goal of medical treatment is to reduce the pressure before it causes glaucomatous loss of vision. Medical treatment is always initiated for those people who are believed to be at the greatest risk for developing glaucoma (see When To Seek Medical Care) and for those with signs of optic nerve damage. How your eye doctor chooses to treat you is highly individualized. Depending on your particular situation, you may be treated with medications or just observed. Your doctor will discuss the pros and cons of medical treatment versus observation with you. Your intraocular pressure is evaluated periodically using guidelines similar to these: Follow-up visits may also be scheduled for the following reasons:
The ideal drug for treatment of ocular hypertension should effectively lower intraocular pressure, have no side effects, and be inexpensive with once-a-day dosing; however, no medicine possesses all of the above. When choosing a medicine for you, your eye doctor prioritizes these qualities based on your specific needs. Medications, usually in the form of medicated eyedrops, are prescribed to help lower increased intraocular pressure. Sometimes, more than one medicine is needed. See Understanding Glaucoma Medications. Initially, your eye doctor might have you use the eyedrops in only one eye to see how effective the drug is in lowering the pressure inside your eye. If it is effective, then your doctor will most likely have you use the eyedrops in both eyes. See How to Instill Your Eyedrops. Once a medicine is prescribed, you have regular follow-up visits with your eye doctor. The first follow-up visit is usually 3-4 weeks after beginning the medicine. Your pressures are checked to ensure the drug is helping to lower your intraocular pressure. If the drug is working and is not causing any side effects, then it is continued and you are reevaluated 2-4 months later. If the drug is not helping to lower your intraocular pressure, then you will stop taking that drug and a new drug will be prescribed. Your eye doctor may schedule your follow-up visits in accordance with the particular drug you are taking, because some medicines (e.g., latanoprost [Xalatan], travoprost [Travatan], bimatoprost [Lumigan]) may take 6-8 weeks to be fully effective. During these follow-up visits, your eye doctor also observes you for any allergic reactions to the drug. If you are experiencing any side effects or symptoms while on the drug, be sure to tell your eye doctor. Generally, if the pressure inside the eye cannot be lowered with 1-2 medicines, you might have early primary open-angle glaucoma instead of ocular hypertension. In this case, your eye doctor will discuss the appropriate next steps in your treatment plan. Laser and surgical therapy are not generally used to treat ocular hypertension, because the risks associated with these therapies are higher than the actual risk of developing glaucomatous damage from ocular hypertension. However, if you cannot tolerate your eye medications, laser surgery could be an option, and you should discuss this therapy with your eye doctor. Depending on the amount of optic nerve damage and the level of intraocular pressure control, people with ocular hypertension may need to be seen from every 2 months to yearly, even sooner if the pressures are not being adequately controlled. Glaucoma should still be a concern in people who have elevated intraocular pressure with normal-looking optic nerves and normal visual field testing results or in people who have normal intraocular pressure with suspicious-looking optic nerves and visual field testing results. These people should be observed closely because they are at an increased risk for glaucoma. Ocular hypertension cannot be prevented, but through regular eye examinations with an eye doctor, its progression to glaucoma can be prevented. The prognosis is very good for people with ocular hypertension. Educating people with glaucoma is essential for medical treatment to be successful. The person who understands the chronic (long-term), potentially progressive nature of glaucoma is more likely to comply with medical treatment. Numerous handouts about glaucoma are available, two of which are listed below. Also, see For More Informationand Web Links. American Academy of Ophthalmology Lighthouse International American Academy of Ophthalmology Glaucoma Research Foundation Prevent Blindness American The Glaucoma Foundation Lighthouse International Media file 1: Parts of the eye. Media file 2: Elevated eye pressure is caused by a build-up of fluid inside the eye because the drainage channels (trabecular meshwork) cannot drain it properly. Elevated eye pressure can cause optic nerve damage and vision loss. Synonyms and KeywordsOHT, Ocular Hypertension Treatment Study, OHTS, high pressure inside the eye, glaucoma, glaucoma suspect, primary open-angle glaucoma, primary open angle glaucoma, POAG, intraocular pressure, IOP, increased IOP, elevated IOP, high IOP, increased intraocular pressure, elevated intraocular pressure, high intraocular pressure, high eye pressure, elevated eye pressure, increased eye pressure, optic nerve, optic nerve damage, visual field defect, vision loss, blindness, ocular hypertension How do you get rid of pressure behind your eyes?Treatment options. ibuprofen, aspirin, or acetaminophen to treat headaches.. antibiotics, steroid nasal sprays, or antihistamines to treat sinus infections.. What causes pressure eye pain?Migraines and tension headaches
Tension and migraine headaches are two types of headaches that can induce a sense of pressure behind the eyes. Tension headaches are the most frequent type of headache, with over 80% of people suffering from them.
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