High IOP in teen

Hi,
I took my 17 year old son for a routine eye exam two weeks ago.  His vision was perfect, 20/20 but his eye pressure was 18 and 23.  The reading was taken at around 5:30 p.m.  The optometrist wanted to re-check his eyes and he was seen again two days ago in the morning at around 9:00 am.  His eye pressure had increased to 22 and 27.  The doctor says his optic nerves look fine, his peripheral vision is fine but has referred him to an ophthalmologist anyway.
I have been worrying as I read that tumors or glaucoma can cause high intra-ocular pressure.  Could this be just a normal high for him?  He has no other problems or symptoms.  What measures can be taken to reduce the pressure?
Thanks much.
Worried Mom

[John C Hagan III, MD, FACS, FAAO]

I wouldn't worry much about tumors. That IOP is too high. One test they will likely do at the eye MD office is measure central corneal thickness. If thick the true IOP could be much lower. (thick cornea better).

JCH MD

[Harini]

Thanks, Dr. Hagan.  Can the pressure be reduced by medication alone and if it is glaucoma can it be arrested?  Are there any long-term side effects due to the medication?  How do they measure the thickness of the cornea?
Sorry for all these questions!

[John C Hagan III, MD, FACS, FAAO]

1. Glaucoma is really a collection of many types of different diseases so it cannot be generalized.  You can Google "glaucoma" or go on Eye MD for more information.
2. All mediciations have some potential for side effects. Modern glaucoma medications are relatively free of serious complications.
3. The cornea thickness is measured with a pachymeter that does it painlessly in less than a second.

JCH MD

[Harini]

Thanks, Doctor!

[John C Hagan III, MD, FACS, FAAO]

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