What Is High Eye Pressure?

IOP is a special phenomenon that is gradually recognized in the diagnosis and treatment of primary open-angle glaucoma after decades of clinical practice. It has also been confirmed in clinical work that the vast majority of patients with clearly diagnosed glaucoma have the common characteristics of elevated intraocular pressure. Although ocular hypertension develops slowly and causes less damage to the optic disc and visual field, after all, it has an important pathological factor in common with open-angle glaucoma, namely, increased intraocular pressure.

Basic Information

nickname: High intraocular pressure, high intraocular pressure, benign ocular hypertension, etc.
English name: ocular hypertension
English alias: ocular hypertensive
Visiting department: Ophthalmology

Multiple groups: Women over 40
Common causes: Changes in women's endocrine system, autonomic nervous system dysfunction, cyclical changes of adrenal hormones in the body, etc.
Common symptoms: Optic disc hemorrhage

Causes of ocular hypertension

Data show that female patients, increased blood pressure, and winter are associated with high intraocular pressure.

1. There are many women with ocular hypertension, and most of them are over 40 years old, suggesting that there may be a certain relationship with women's endocrine changes, especially pre-menopausal autonomic dysfunction.

2. The explanation of the accompanying phenomenon of elevated blood pressure and elevated intraocular pressure is also related to the autoregulation of autonomic nervous function of blood vessels.

3. The relationship between intraocular pressure and seasonal changes and day-to-day changes (often higher in the morning) is considered to be related to the periodic changes in adrenal hormones in the body.

4. Systemic factors related to high intraocular pressure include race (more common in blacks), height, weight and pulse rate, diabetes and smoking.

Clinical manifestations of ocular hypertension

Only the intraocular pressure increased, and the optic disc and visual field were not damaged. The development of high intraocular pressure is a slow and benign process. Through long-term observation, the IOP of most people with high intraocular pressure is stable, and even has a downward trend. This is in sharp contrast to the slow progressive increase of open-angle glaucoma. Optic disc bleeding is considered to be a sign of the transition to open-angle glaucoma Most of them are located at the upper and lower poles of the optic disc, and the lower poles are more common. The patients with high intraocular pressure should be closely followed up and observed.

Ocular hypertension

Cup-to-disk ratio

It has long been the most commonly used indicator for clinically describing glaucomatous optic neuropathy. Normal retinal cup-to-disc ratio (C / D value) of most of the eyes does not exceed 0.4, if it exceeds 0.6 or the C / D difference between the two eyes exceeds 0.2, attention should be paid to it. Regular follow-up shows that the progressive deepening of the optic disc depression is more diagnostic in glaucoma.

Visual field inspection

Traditional visual field examinations, such as the Goldmann perimeter arc perimeter, are qualitative tests that are dynamic visual fields, which have been difficult to use as a diagnosis of early glaucoma. The visual field examination for early glaucoma is mainly a static visual field with threshold quantitative detection, that is, the actual sensitivity of each point in the visual field is measured, and small changes can be monitored and statistical probability judgments can be made.

3. Other visual function checks.

Diagnosis of ocular hypertension

1. IOP 30mmHg.

2. Have a family history of positive glaucoma.

3. The contralateral eye is primary open-angle glaucoma.

4. High myopia.

5. Large disc depression.

6. Accompanied by systemic hemodynamic and hemorheological abnormalities that can cause optic disc hypoperfusion, such as diabetes, hypertension, history of cerebrovascular stroke, peripheral vasospasm, hyperviscosity, etc.

Differential diagnosis of ocular hypertension

Hypertensive disorder has only elevated intraocular pressure to varying degrees, without optic disc damage and visual field defect, which is different from other types of glaucoma.

Treatment of ocular hypertension

The most important treatment of ocular hypertension is close follow-up, mainly to monitor changes in intraocular pressure, fundus optic disc shape, and visual field. If the intraocular pressure is always at a high level (such as 25mmHg), or the intraocular pressure continues to increase, the retinal morphology of the fundus (preferably with quantitative analysis) and threshold visual field should be detected every 6 months. If accompanied by high-risk factors or obvious adverse factors during follow-up, medical treatment can be given as appropriate. However, laser or surgical treatment is generally not recommended, because the eye damage caused by the latter two will be irreversible. If medical treatment is given, it is also necessary to weigh the pros and cons to choose the appropriate intraocular pressure lowering drug, and to reduce the intraocular pressure to within the normal statistical range as much as possible, or to reduce the basic intraocular pressure by 30%.

Ocular hypertension prevention

Psychological adjustment

When the patient fluctuates, is tired, and works in a dark environment for a long time, the sympathetic nerves are excited, causing pupil dilatation to contract, leading to dilated pupils, sclera accumulation to the periphery, closing the angle of the room, obstruction of aqueous humor, increasing intraocular pressure, and inducing glaucoma attack. Let patients understand that the acute attack of glaucoma is related to the above factors, maintain a happy spirit, have a regular life, and avoid emotional fluctuations.

2. Reasonable diet

Do not smoke, drink alcohol, drink strong tea, coffee, or eat spicy foods. At the same time, properly control the amount of water. It should not exceed 300ml at a time, so as to avoid a large amount of water absorbed into the blood in a short period of time, which will increase the aqueous humor and cause eye pressure. Elevate; eat more vegetables, eat honey, honey can not only reduce intraocular pressure, but also laxative, to avoid increased intraocular fluid secretion and increase intraocular pressure.

3. Rules of life

Reasonable arrangements for daily life, self-relaxation, and keeping the spirit happy; it is not suitable to stay in a dark room or dark environment for too long, because in dark conditions, pupils dilate, iris obstruction has narrowed the angle of the room, the drainage of aqueous humor is blocked, and intraocular pressure High; indoor lighting when watching TV to avoid pupil dilatation; should not lower your head, bend to read and write for a long time; belts, underwear, neckline and bra should not be too tight, to prevent the internal carotid artery pressure from increasing, causing increased intraocular pressure; sleep Pillows should be properly cushioned.

4. Review on time

Many patients in clinical practice often mistakenly believe that glaucoma can be cured after surgery, and no further consultation is needed. Therefore, it is important to explain to patients that although glaucoma IOP is controlled, it does not represent the cure of the disease. It is still necessary to pay attention to changes in intraocular pressure, optic disc and visual field . Review after 1 week of discharge; monthly review thereafter; 3 months later, review every six months. If you see rainbow light, eye pain, blurred vision or vision loss, you should check immediately.