Eye Pressure....

Hi,
Hoping you can help me with something.  My mom is being monitored every 6 months or so for having high eye pressure in one eye.  Her doctor monitors her as her sister has a history of glaucoma.  
Her eye pressure yesterday was "25".  Can you tell me is this considered dangerous?  When would you recommend a glaucoma test - at what number?

Thanks in advance for your help,
Mary

[Michael J Kutryb, MD]

In the general population, 25 would generally be considered to be a little high. The diagnosis of glaucoma, however, is based on  much more than just the pressure.  In fact, at least 20% of patients being treated for glaucoma have pressure lower than 20 (which has traditionally been considered the upper limit of normal.)  Some patients have pressure of 25 or more and are not treated because they have normal optic nerves, normal nerve fiber layer and visual fields and possibly thick corneas.  Some people with pressures of 12 but with thin corneas and advanced optic nerve damage, are put on aggressive treatment regimens.  Glaucoma is a silent disease with no symptoms usually.  If you are over 40, it is very important to have a complete eye exam with an ophthalmologist to be screened for glaucoma among other things.  So it's not a number that determines who is at risk but rather a whole host of possible findings.  It is especially important to see the status of the optic nerve, which takes the damage when glaucoma is present.  Finally, if  you have a family history of glaucoma, you are much more likely to have it also.

MJK MD