Causes of High Eye Pressure (Ocular Hypertension) and Treatment Options

High eye pressure, also called ocular hypertension, is a condition in which too much pressure builds up inside your eyes, leading to damage to your optic nerve and possible vision loss.

High eye pressure (or ocular hypertension) is a condition in which too much pressure builds up inside your eyes. This can cause damage to your optic nerve and lead to vision loss. It is also a major risk factor for glaucoma. 

High eye pressure can only be identified using a special optometric instrument called a tonometer. Once diagnosed, it can be treated using lifestyle changes, medications and surgery. 

Causes of High Eye Pressure

High eye pressure is caused by excess fluid in your eye. This happens for two reasons: your eye produces too much fluid, or it cannot drain fluid that builds up. 

In rare cases, eye injuries and certain medications, especially steroids, can also cause high eye pressure.

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How to Tell if You Have High Eye Pressure

The only way to know for sure if you have high eye pressure is to get tested by your eye doctor. Moderate high eye pressure does not usually cause any symptoms.

If your eye pressure is unusually high, you may notice:

• Halos around objects in your vision
• Blurry vision
• A sensation of pressure around the eyes
• Eye pain

If you experience any of these symptoms, see your eye doctor as soon as possible for eye pressure testing.

Diagnosis

If you are concerned that your eye pressure might be too high, your eye doctor will test it using a special instrument called a tonometer.

You will receive numbing eye drops so that you won’t flinch during the test. Then you will have the tip of the tonometer pressed lightly against your eye, recording your pressure.

Depending on the results, your doctors might check for signs of glaucoma. They may examine your optic nerve using a special light or check your peripheral vision for blind spots.

Risk Factors

You are more likely to develop high eye pressure if you:

• Are older than 40
• Are African American
• Are extra nearsighted
• Have diabetes
• Have a family history of high eye pressure or glaucoma

Complications

High eye pressure can lead to several complications if it is not treated. Among the complications are:

• Bleeding in the eyes
• Optic nerve damage
• Vision loss
• Glaucoma

High Eye Pressure and Glaucoma

High eye pressure significantly increases the risk of developing glaucoma, a group of serious eye conditions hallmarked by visual impairment and that can lead to partial or total blindness.

Every person’s optic nerve can handle a certain amount of pressure. If your pressure exceeds that level regularly, you will develop glaucoma.

If your eye pressure is consistently high, your eye doctor will screen you for glaucoma during your routine visits. Taking steps to lower your eye pressure can help you lower your risk of developing the condition.

When Is Treatment Necessary?

Each eye doctor has a benchmark for when treatment for high eye pressure is necessary. Eye pressure between 20 to 30 mm Hg causes slow damage to the optic nerve over several years, so treatment will usually begin when your readings consistently fall within this range. At 40 to 50 mm Hg, you are at high risk of sudden vision loss.

Treatments

High eye pressure can be treated with many different approaches, including:

• Home remedies and lifestyle treatments 
• Medications
• Medical treatments

Home Remedies and Lifestyle Changes

There are many things you can do to lower your eye pressure without surgery or medication.

• Exercise regularly. People who exercise at least moderately for 30 minutes, three to five times a week, have lower eye pressure than people who are inactive.
• Avoid caffeine. Caffeine raises your blood pressure and increase your eye pressure as a result. 
• Do not smoke. Smoking significantly raises your eye pressure. 
• Sleep with your head elevated. Eye pressure rises significantly during the night. Sleeping with your head at a 30-degree angle from your body lessens this effect.

Medications

Medicated eye drops are the first-line treatment for high eye pressure. They reduce the amount of fluid produced by your eyes or help your eyes expel that fluid faster.

If drops do not lower your eye pressure enough, your doctor may prescribe oral medications as a next step. The prescription drugs, usually carbonic anhydrase inhibitors, reduce the amount of fluid your eyes produce.

Medical Treatments

If your high eye pressure does not respond to medications and lifestyle changes, your eye doctor may recommend other treatments to control the problem. These include:

• Trabeculectomy. This surgery creates a small incision in your eye’s outer structures to drain some of the fluid from inside it. 
• Laser trabeculoplasty. This surgery alters the drainage angle of your eye, allowing excess fluid to drain from it more easily. 

Neither of these treatments is guaranteed to work. Either one may need to be performed multiple times or combined with other treatments to produce the desired results. 

Prevention

To prevent high eye pressure, schedule regular eye exams with your eye doctor. This will allow them to monitor your eye pressure over time and initiate early treatment if necessary. 

Let your doctor know about any risk factors that apply to you so they can determine how frequently your eye pressure should be checked.

FAQs

How can I lower my eye pressure?

You can lower your eye pressure at home by exercising regularly, reducing your caffeine intake, not smoking and sleeping with your head elevated. You should also take any medications your eye doctor prescribes for this problem. 

What happens if your eye has high pressure?

If high eye pressure is left untreated, it will damage your optic nerve and put you at risk for vision loss and glaucoma. It is important to take steps to lower your eye pressure as soon as you are aware of the problem. 

Can eye pressure go down on its own?

Yes, eye pressure can go down without medical treatment. But it will likely require some lifestyle adjustments. Getting regular exercise and avoiding caffeine and smoking will help you lower your eye pressure on your own. 

References

1. What Is Ocular Hypertension? (May 2022). American Academy of Ophthalmology. 

2. Lifestyle, Nutrition and Glaucoma. (August 2010). Journal of Glaucoma.

3. Glaucoma. (April 2022). National Eye Institute. 

4. Glaucoma—1: Diagnosis. (January 2004). British Medical Journal. 

5. Twenty-Four–Hour Pattern of Intraocular Pressure in Untreated Patients with Ocular Hypertension. (January 2013). Investigative Ophthalmology & Visual Science. 

6. Glaucoma and Eye Pressure. (March 2022). National Eye Institute.

7. What is trabeculectomy? (2022). Johns Hopkins Medicine. 

8. Laser Trabeculoplasty for Glaucoma. (August 2020). HealthLink BC. 

9. Ocular hypertension. (2022). American Optometric Association.