Introduction  

Ocular hypertension is a condition whereby a person’s eye pressure (intraocular pressure) is above the normal range. With this condition, the front of one’s eyes doesn’t drain fluid properly. As a result, the eye pressure builds up. Ocular hypertension is different from glaucoma because the affected optic nerve appears normal and the affected person does not show any signs of vision loss.
Eye doctors measure eye pressure in the form of millimeters of mercury (mm Hg). One is deemed to have normal eye pressure if it is between 10-21 mm Hg. With ocular hypertension, eye pressure is above 21 mm Hg

Causes and Risk Factors

The human eye has a clear fluid known as aqueous humor. This fluid flows in the front of the eye.The eye synthesizes aqueous humor with some of it flowing out of the eye. This is necessary for steady eye pressure. In cases where the aqueous humor does not flow out of the patient’s eye normally, pressure accumulates which may lead to ocular hypertension.
If high eye pressure damages the optic nerve, one is likely to suffer from glaucoma which ultimately results in vision loss.
Ocular hypertension is also caused by an eye injury or some eye diseases. This condition may also be brought about by medications like steroids which raise eye pressure.
Anyone can suffer from ocular hypertension; however, some people are highly susceptible to ocular hypertension more than others. These includes people who:

  • Are above 40 years
  • Are Hispanics and African-Americans
  • Are suffering from high blood pressure or diabetes
  • Have undergone surgery or are suffering from eye injuries
  • Have exfoliation syndrome and pigment dispersion syndrome
  • Are on steroid medications
  • Have a family history of glaucoma or ocular hypertension
  • Are nearsighted
     

Signs & Symptoms

Most cases of ocular hypertension go undetected. This is the reasons why individuals who are at risk of are advised to go for regular eye exams.

Diagnosis

The eye care professional will measure the patient’s eye pressure. During this diagnosis, the patient’s eye will be numbed using eye drops. The doctor will then use a gadget called a tonometer for measuring how the cornea reacts to pressure. This will help him/her determine the pressure of the patient’s eyes. The doctor will further check for signs of glaucoma. He/she will check the patient’s optic nerve to see whether there are any signs of damage and to also check their side vision.

Treatment 

Treatment of ocular hypertension is aimed at lowering the patient’s eye pressure before it results in vision loss or damages their optic nerve.

Medical Treatment

The eye care doctor may recommend eye drop medicine to lower eye pressure. Depending on the drug that the doctor will prescribe, some medications last up to 8 weeks before being fully effective. Some of the medicines the doctor may prescribe include latanoprost, travoprost, and bimatoprost.

Surgical Treatment

In serious cases, the eye care professional may prescribe surgery. The surgeon might perform a surgical treatment known as laser trabeculoplasty to lower the patient’s eye pressure.

Prognosis/Long-term outlook

The major complication with ocular hypertension is the advancement of the disease to primary open-angle glaucoma. Here, the optic nerve's function or structure changes as reflected in changes with one’s visual field.
Depending on the level of optic nerve damage and intraocular pressure, patients suffering from ocular hypertension need to see a doctor regularly. Glaucoma is a major concern for people suffering from high intraocular pressure. Many of these patients have healthy looking optic nerves and pass visual field tests. For this reason, they should be closely monitored because they stand a high risk of suffering from glaucoma.
Patients who comply with medical treatment and visit their eye doctor stand a less chance of getting glaucoma. However, with poor follow-up care and control of intraocular pressure, the optic nerve and visual field may be compromised leading to glaucoma.

Prevention/Follow Up

There is no way of preventing ocular hypertension. However, it is important to start treating it early. Through regular eye tests, patients may be able to prevent the condition from progressing to glaucoma.