Ocular hypertension is when the pressure inside the eye (intraocular pressure or IOP) is higher than normal. With ocular hypertension, the front of the eye does not drain fluid properly. This causes eye pressure to build up. Higher than normal eye pressure can cause glaucoma. Glaucoma is a disease where eye pressure damages the optic nerve, causing vision loss. Ocular hypertension is not the same as glaucoma. With ocular hypertension, the optic nerve looks normal and there are no signs of vision loss. However, people with ocular hypertension are at increased risk for glaucoma and are considered “glaucoma suspects.” Ocular hypertension usually does not have any signs or symptoms. Because you can have high eye pressure and not know it, it is important to have regular eye exams with your ophthalmologist to check for glaucoma.

What Causes Ocular Hypertension?

A clear fluid called aqueous humor flows inside the front of your eye. Your eye continually makes aqueous humor while an equal amount of it flows out of your eye. This keeps a constant healthy eye pressure. If the aqueous humor does not flow out of the eye properly, pressure builds up and causes ocular hypertension. If high pressure causes damage to the optic nerve, it leads to glaucoma. Glaucoma causes vision loss.

Who Is at Risk for Ocular Hypertension?

Anyone can develop ocular hypertension, but some people have a higher risk for this condition. They include:

• those with family history of ocular hypertension or glaucoma
• people who have diabetes or high blood pressure
• people over age 40
• African-Americans and Hispanics
• people who are very myopic (nearsighted)
• people who take long-term steroid medications
• people who have had eye injuries or surgery
• those with pigment dispersion syndrome or pseudo exfoliation syndrome (PXF)

How Is Ocular Hypertension Diagnosed?

Your ophthalmologist will measure the pressure in your eye. During this test, your eye is numbed with eye drops. Your doctor uses an instrument called a tonometer to measure how your cornea resists slight pressure. This helps determine your eye pressure. Your ophthalmologist will also check for glaucoma. They will examine your optic nerve for signs of dam age, and check your side (peripheral) vision.

How Is Ocular Hypertension Treated?

It is important to lower high eye pressure it before it causes vision loss or damage to the optic nerve. If your eye pressure is only slightly elevated, your ophthalmologist may decide not to start treatment right away. He or she will monitor pressure with regular testing instead. However, your ophthalmologist may decide that you need eye-drop medicine to lower your intraocular pressure. They will schedule a visit within several weeks of starting the medicine to see how it is working. Sometimes, your ophthalmologist may prescribe more than one medicine. It is important that you follow the directions exactly for the drops to work. Sometimes, laser or surgery is used to lower eye pressure. Treatment decreases your risk of glaucoma, but it does not eliminate the risk. Some patients with ocular hypertension may go on to develop glaucoma. If that happens, your ophthalmologist will talk with you about treatment options. If you have any questions, be sure to ask them. Your ophthalmologist is committed to protecting your sight.