Doctor's Notes on Ocular Hypertension
Ocular hypertension is pressure of greater than 21 mm Hg in one or both eyes on two or more occasions. It is not considered a disease but as a symptom of a tendency to develop open-angle glaucoma. Ocular hypertension has no signs or symptoms. If it is found, the patient should be regularly observed for the development of glaucoma. Glaucoma is an eye disease where the optic nerve is damaged and accompanied by ocular hypertension.
The cause of ocular hypertension is an imbalance in the production and drainage of the fluid (aqueous humor) of the eye. In most individuals, the problem is with poor drainage not overproduction.
What Is the Treatment of Ocular Hypertension?
The treatment of ocular hypertension is to reduce pressure in the eye before it can cause loss of vision. The decision to treat is based on general guidelines and is often begun if the ocular pressure is 28 mm Hg or higher. Medications are in the form of eyedrops (some patients require two types of drops):
Follow-up is important as it may take 6-8 weeks for a drug to be effective. Surgery is not usually used to treat this problem but if medicines fail, laser surgery may be considered.
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GlaucomaGlaucoma can be caused by a number of eye diseases that can damage the optic nerve, typically by elevating pressure inside the eye, which is called intraocular pressure (IOP) or ocular hypertension. Symptoms begin slowly and include vision loss and irregularities, eye pain, headache, nausea, and vomiting. Beta-blockers, Alpha-adrenergic agonists, and prostaglandin analogs are drugs used to treat glaucoma. Sometimes surgery is necessary, especially with congenital glaucoma. The disease is not curable but can be managed.
Glaucoma FAQsGlaucoma is usually high pressure inside the eye that damages the optic nerve and can result in permanent vision loss. While high pressure inside the eye, damage to the optic nerve and vision loss are common criteria for diagnosing glaucoma, glaucoma can be present without all three of these criteria. The two main types of glaucoma are open-angle and angle-closure glaucoma. Glaucoma may be symptomless until significant permanent vision damage has occured, but may show symptoms as well, including pain, redness, haloes, and blurred vision.
Normal-Tension GlaucomaNormal-tension glaucoma or low-tension glaucoma is a condition in which the optic nerve is damaged despite normal fluid pressure inside the eye (other types of glaucoma result vision loss because of abnormally high pressure inside the eye. Normal-tension glaucoma typically occurs in older adults and can be caused by congenital nerve defects and irregularities in blood flow to the eye. Eyedrops and surgery are treatments for this disorder.
Primary Open-Angle GlaucomaGlaucoma describes chronic high pressure within the eyeball. The pressure eventually causes nerve damage, though glaucoma can still occur without elevated pressure. Primary open-angle glaucoma is a subtype of the disease characterized by atrophy of the optic disc in the back oif the eye and other problems.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.