Ocular Hypertension

Ocular Hypertension

Regular eye examinations with an ophthalmologist are important to screen for ocular hypertension and primary open-angle glaucoma. In particular, regular eye examinations are critical for those people who are at high risk, such as blacks and elderly persons.

• For people without any symptoms and who are aged 40 years and younger, screenings should be performed at least every 3-5 years.
• Screenings should be conducted more often if the person is black or older than 40 years.
• For people with multiple risk factors for glaucoma, evaluation/monitoring should be performed on an even more frequent basis.

Your initial visit to the ophthalmologist is extremely important in the evaluation of ocular hypertension to detect glaucoma  or other ocular diseases that could be causing elevated intraocular hypertension (called secondary glaucoma).

During this visit, the ophthalmologist will ask you about the following:

• Past ocular history
• Eye pain or redness
• Multicolored halos
• Headache
• Previous eye disease, eye surgery, or eye/head trauma

Past surgeries or illnesses

Current medications (Some medications may indirectly cause changes in intraocular pressure.)

Strong risk factors for optic nerve damage due to glaucoma

• History of elevated intraocular pressure
• Advanced age, particularly people who are older than 50 years
• African American descent
• Family history of glaucoma
• Nearsightedness (myopia)

Possible risk factors for optic nerve damage due to glaucoma

• Heart disease
• Diabetes
• Migraine headache
• Hypertension (high blood pressure)
• Vasospasm (a spasm or constriction of the blood vessels)

Other possible risk factors

• Obesity
• Smoking
• Alcohol use
• History of stress or anxiety (no definitive link to ocular hypertension)

Self-Care at Home

If your ophthalmologist prescribes medicines (see Medical Treatment and medications) to help in lowering 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 (ie, glaucoma).

Follow-up

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.

Prevention

Ocular hypertension cannot be prevented, but through regular eye examinations with an ophthalmologist, its progression to glaucoma can be prevented

Outlook

The prognosis is very good for people with ocular hypertension.

• With careful follow-up care and compliance with medical treatment, most people with ocular hypertension do not progress to primary open-angle glaucoma, and they retain good vision throughout their lifetime
• With poor control of elevated intraocular pressure, continuing changes to the optic nerve and visual field that could lead to glaucoma might occur.