Ocular hypertension

[arnie76]

I am a 33 year old male basically from India. I went to a vision clinic for a regular eye-check up. The optometrist found a high IOP [ 26 - left & 25 -Right ]. He was concerned about this and asked me to come on a follow-up 2 weeks later. Today I went for the follow-up and he measured the IOP again [with some thing called Tanometer-like an air puff]. He said the reading was around 30 on each eyes.
He checked my peripheral vision test and said it was perfect. Also as per him, the optic nerve looks good. He was sure that I don't have glaucoma but he said I have something called Ocular hypertension.
He referred me to see an Ophthalmologist.

I am very much worried. I read some articles in the Internet that this condition can be treated and I might not develop Glaucoma at a later stage. Is that correct ?

[arnie76]

Dr Hagen,

Can I please request your expert opinion on my case.
I have been having regular visits to my Eye MD at interval of 3-6 months since my first visit and my IOP has been always in the range of 25-26 on both eyes.

My Eye MD did  gonioscopy, my corneal thickness [which turned out to be normal thickness] and he said everything looks fine and I haven't developed Glaucoma yet. He is asking me to visit him every 6 months now on.

I don't have any family history of Glaucoma.

My question is that is this a good approach to wait and watch ? Or should I be put on medication so that  this OHT doesn't develop to Glaucoma in future.

I would highly appreciate your expert opinion on this. Also do you suggest me to have a second opinion with another Eye MD

[arnie76]

Hello Dr Oyakawa

I had an appointment with an ophthalmologist who is a Glaucoma specialist as per the doctor's office.
He reviewed my IOP with Goldman Tanometer and found be high [ around 30]. He then measured the cornea thickness and said it's average [ around 555]. He told me he feels the optic nerver looks perfect and he doesn't want to start treatment but watch me carefully.
He called me for another appointment in 3 months and said he will do the nerve tomography then.

I would be happy to receive your expert comments on this please.

[arnie76]

Many thanks, Doctor.
I hope I will get an appointment with the ophthalmologist soon.

[Ray T Oyakawa, MD]

There are many factors.  First the the air puff tonometer frequently reads high.  

When you see the ophthalmologist he will do a complete exam, check you eye pressure with a Goldman Tonometer, do a visual field test (most, but not all optometrist use a less sophisticated perimeter),  check your corneal thickness (thick cornea read a higher eye pressure),evaluate your angles with gonioscopy (look at the drainage system of the eye which can be compromised in glaucoma), and do an evaluation for the optic nerve.  The best way to evaluate the optic nerve at this time with a spectal domain OCT machine.  These scanner can often detect damage to the optic nerve before one develops visual field defects.

You will need to take eye drops if you do have ocular hypertension that later develops into glaucoma.  Most patients with glaucoma do well.  Think of it as high blood pressure of the eye.  If controlled you will not loose vision.

Dr. O.