What You Should Know About Ocular Hypertension
Chances are that you’ve experienced high blood pressure every now and then. After all, blood pressure levels change about as often as air pressure systems on a weather map.
Even those in great health can elevate their BP after one or two extra cups of coffee, vigorous exercise, or a stressful life experience. That’s normal. What’s abnormal is hypertension, signaled by multiple days/weeks/months in a row of higher-than-normal blood pressure.
The most common triggers for hypertension include obesity, smoking, high-salt diets, excessive alcohol intake, and heredity. As an example of the hereditary factor, over 40 percent of African Americans deal with hypertension, possibly due to a unique genetic trait that makes them sensitive to salt. But genetic predisposition can happen to anyone, regardless of race.
Even on its own, hypertension is a serious medical issue. But did you know that hypertension may also lead to eye problems? The ocular disease most related to hypertension is hypertensive retinopathy, which is usually accompanied by headaches and vision problems. Ocular hypertension, however, isn’t necessarily connected to hypertension, and generally has no symptoms at all.
Ocular hypertension is one of many possible eye problems that involve elevated pressure. But in this case, it’s internal eye pressure r
ather than blood pressure.
Causes of Ocular Hypertension
Ocular hypertension occurs when the internal pressure of the eye increases beyond normal limits (generally, above 21 mm of mercury, or Hg). Retinal specialists also refer to eye pressure as intraocular pressure (IOP). A normal IOP is 10-21 mm Hg.
The reason for the increased eye pressure has a lot to do with optical fluid imbalances and malfunctioning drainage capacity. Simply put, your eye builds up more fluid than it’s able to drain. If the problem isn’t addressed, all that extra pressure may predispose you to glaucoma and optic nerve damage.
If you’ve injured your eye(s), your injury may create further fluid imbalances and drainage problems, even months after the injury. Likewise, other eye conditions like corneal arcus or pseudoexfoliation syndrome may be linked to ocular hypertension.
Even an activity as innocent as playing a brass or wind instrument can increase IOP, due to the extra pressure of the lips and facial muscles while creating higher-frequency pitches. If you’re a professional brass or wind player, see your eye doctor regularly.
Occasionally, various medications can lead to higher IOP. Examples include asthma medications and other steroids (even eye drops containing steroids may carry risks for certain individuals). Always tell your doctor about your medications before each exam. Your doctor may need to visit with you more often in such cases.
The Importance of Regular Eye Exams
As mentioned earlier, ocular hypertension is unlike hypertensive retinopathy, in that it has no obvious symptoms. This is one reason
why regular eye exams are so critical. Your optical practitioner checks your eye pressure during each exam. In most cases, your eye pres
sure will lie within normal limits.
Even if you’re diagnosed with ocular hypertension, does this mean your eyesight will be at risk? Not necessarily. But it’s helpful to view ocular hypertension with caution, as it can signal a higher risk for glaucoma (and glaucoma can damage your optic nerve, and-therefore-your sight).
Starting at about age 40, you increase your risk for ocular hypertension, which-on average-impacts 3- 5% of those 40 and above. Diagnosis hinges on early detection, so make plans to see your eye doctor annually.
Because each patient is unique, so is the treatment. Your eye doctor may decide to monitor your condition for a time without prescribing any outside treatment. In many cases, though, you’ll use prescription eye drops to help reduce the pressure.
No medication is completely free from side effects, which is just one reason why many eye care professionals recommend monitoring first. If you do take medications without any perceived change in IOP, your doctor may recommend other options. Most commonly, those involve a change in drug.
If your eye pressure is above 28 mm Hg, you risk damage to the optic nerve. Your doctor usually prescribes a drug and follows up a month later. He or she may also order a gonioscopy if your IOP increases (whether or not you’re on medications). Additionally, you should expect your doctor to take photos of the back of your eye to track any changes to the optic nerve.
If your ocular hypertension doesn’t change despite multiple medications, you may have an early type of glaucoma. Keep in mind, however, that most patients with ocular hypertension respond positively to medications and other therapies. The majority keep healthy vision and avoid glaucoma with careful observation.
Support and Education
A relatively small percentage of Americans is diagnosed with ocular hypertension each year. You can increase your chances of a clean bill of eye health by visiting your eye doctor regularly.