eye pressure

[susie1130]

My eye check up doctor said my pressure was 23 he said we need to keep an check on this as it should be at 15 for normal and could lead to glaucoma...is this true?

[Houman Vosoghi, MD]

Once or twice a year an OCT of the nerves should be performed as the newer versions of this can pick up very early changes in the nerve fiber layer before perimetry and optic nerve visualization can.  Yes, they can pick up normal pressure glaucoma.

HV

[Houman Vosoghi, MD]

These days with our current technology, just monitoring the pressure is not adequate.  You should see a glaucoma specialist (ophthalmologist with fellowship training in glaucoma) for a full glaucoma evaluation to make sure you do not have the early signs of glaucoma.  He/she could check you for narrow angle glaucoma (gonioscopy), pigment dispersion, pseudo-exfoliation, etc. as these are causes of glaucoma frequently missed by non-specialists and they could also perform an optic nerve OCT exam which will demonstrate whether there is any early damage from glaucoma.  This exam will determine how frequently your eye pressures and optic nerves should be checked.  Find one at www.aao.org and search by specialty for glaucoma.

HV

[ledbrv]

Dr. Houman,

Good to know there are more resources.
Can these exams you mention detect a glaucoma even with normal IOP ?
I have open angle glaucoma (for about 4 years), and  my doctor does frequently is IOP monitoring, but he also does other exams less frequently.
I don`t know these exames names in english.
In one of them he dilates my pupil to observe the optical nerve, I think the other exam is called perimetry.
Until now, these exams showed that the optical nerve damaged is not increasing.
In fact, I did a perimetry yesterday, and the result for my OD is better then in the last perimetry (I had a cataract surgery in this eye a month and half ago).
He also sent me to a glaucoma especilist once and are about to send me again.
In your opinion, Is there any other exam I should do ?

Thanks for your help.

[ledbrv]

I forget to mention. As far as I know, for now there is no cure for this condition. You will have to use IOP control drops for the rest of your life. But you will get used to it.

[ledbrv]

Yes ! That is certainly true ! Glaucoma is one of the principle cause of blindness all over the world. As cwatt1 said it is a "silent" disease. But don`t be worried, if you didn`t notice any lost of vision, your doctor find it at the beginnig. You will have to visit your doctor regularly for internal ocular pressure (IOP) monitoring. Probably he will prescribe one or more drops 1 or 2 times a day. This drops will keep your IOP below 20. I have glaucoma for 5 years now. At the beginning my IOP was above 20, now it keeps between 15 and 17. I don`t notice any lost of vision and my exams shows everything is fine.

[cwatt1]

Elevated eye pressure should be checked frequently.  High pressure over a period of time can lead to damage to the optic nerve.  Most forms of glaucoma are slow developing and painless, so the only way to keep tabs on it is frequent exams.  Definitely follow your doctor's advice.