high IOP and high cup disc ratios

My lovely son is a very healthy 19 year old boy who has never had any medical problems or eye problems. He went for a regular eye check at the opticians and for the first time ever had his eye pressures done as part of the exam. They were 22 and 24 respectively i.e. 'high' and his cup disc ratios were Left eye 0.4 and Right eye 0.6 which I believe is also 'high' . So as a result of this (i.e. high IOP and high and asymmetrical cup disc ratios) we have been referred now to see a specialist which we will be doing in two weeks time. My son has never had any vision problems and we were at the optician just for spectacles for very mild shortsightedness and now we seem to be on the way to a diagnosis of glaucoma. There's no glaucoma in the family. Is it possible that a) his eye pressures could have been high due to high anxiety during the test (he hates anyone touching his eyes and he actually fainted immediately after the eye pressure test and b) is the cup disc ratio definitely abnormal or could this be a 'normal' variation? Or should I be preparing myself (and him) for potentially bad news i.e. glaucoma?

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

No anxiety will not raise IOP. IF he sqeezes while the test is done that will raise IOP falsely.  It's not likely he has glaucoma. The news is likely to be good. C/D ratios are notoriously hard to standarzie. 0.4 is normal 0.6 is slighly high.

JCH MD