High pressures in eyes
Discussion
Hi all, any opticians out there who can advise?
I'll start by saying I always seem to have high pressure in my eyes when I have an eye test. One optician once put it down to tensing up so much when getting ready for the puff of air! One optician even referred me to the eye hospital some 15 years ago but I was sent home without issue.
I have worn glasses for 25 years (not strong -1.5).
However, today I thought I'd have a free consultation for laser eye surgery. The consultant didn't use a puff of air, he used a blue light (which basically was touching my eyeball) and he said was better than the puff of air. I could feel myself tensing up worse than the puff of air! Result is a reading of 36 in one eye and he couldn't get a reading in the other.
He's refusing to discuss laser eye surgery and wants to discuss gloucoma management. Has put me on drops (Xalatan?).
How worried should I be? He said it should be below 20. Is there another test they can do for gloucoma rather than these? I have incredibily sensitive eyes anyways, and I just feel these tests aren't a proper result due to my inability to relax for the tests.
Thanks all.
I'll start by saying I always seem to have high pressure in my eyes when I have an eye test. One optician once put it down to tensing up so much when getting ready for the puff of air! One optician even referred me to the eye hospital some 15 years ago but I was sent home without issue.
I have worn glasses for 25 years (not strong -1.5).
However, today I thought I'd have a free consultation for laser eye surgery. The consultant didn't use a puff of air, he used a blue light (which basically was touching my eyeball) and he said was better than the puff of air. I could feel myself tensing up worse than the puff of air! Result is a reading of 36 in one eye and he couldn't get a reading in the other.
He's refusing to discuss laser eye surgery and wants to discuss gloucoma management. Has put me on drops (Xalatan?).
How worried should I be? He said it should be below 20. Is there another test they can do for gloucoma rather than these? I have incredibily sensitive eyes anyways, and I just feel these tests aren't a proper result due to my inability to relax for the tests.
Thanks all.
Edited by audi321 on Friday 29th July 10:20
I'm a retired optometrist. The method of measurement used is an applanation tonometer and relies on measuring pressure directly by pressing against the eyeball. It is accurate and it doesn't matter if you tense up. 36mm Hg is high and you are now on treatment which is good news. Do as you are told and keep taking the drops as prescribed and the pressures, fingers crossed, should be brought under control. but you will probably be on drops permanently.
This is interesting to me because of my elevated risk for sudden glaucoma, due to the physiology of my eyes. I have narrow angle glaucoma risk - meaning that the part of my eye where the transfer of vitreous fluid from the front to the back of my eye is narrower than ideal.
My pressures are a normal 21 and 21, but I have had a minor surgical procedure (laser iridotomy) and use Timolol drops daily. The iridotomy is essentially creating a small hole in the iris that allows fluid transfer, in addition to the natural structures at the edge of the iris.
One thing my optometrist does NOT do, is dilate my eyes for examinations, due to risk of a sudden increase in vitreous pressure.
My pressures are a normal 21 and 21, but I have had a minor surgical procedure (laser iridotomy) and use Timolol drops daily. The iridotomy is essentially creating a small hole in the iris that allows fluid transfer, in addition to the natural structures at the edge of the iris.
One thing my optometrist does NOT do, is dilate my eyes for examinations, due to risk of a sudden increase in vitreous pressure.
Glaucoma is more than just high eye pressure. It's when there's evidence of damage to the optic nerve from that pressure (which actually can be normal).
The best way to measure pressure is with the blue prism thing you experienced. And you need to relax to ensure the reading is accurate. Pressure on the eyelid can definitely change the reading so I don't see why squeezing your eyes couldn't. And if the consultant couldn't even check the pressure on one side it suggests you are very squeezy. But you have to have an accurate measurement done on both so you and they need to try again.
And to help measure for damage you need visual field tests, usually an OCT scan of the nerve head and retina and for a complete glaucoma exam you should have a mirror lens placed on your eye to check the depth of the front of the eye to see if you need laser (like one poster above has had).
Also when you've had a PI you should absolutely be fine to dilate and your optom will do you a disservice if they miss a retinal problem for the extremely low chance of spiking your pressure.
The best way to measure pressure is with the blue prism thing you experienced. And you need to relax to ensure the reading is accurate. Pressure on the eyelid can definitely change the reading so I don't see why squeezing your eyes couldn't. And if the consultant couldn't even check the pressure on one side it suggests you are very squeezy. But you have to have an accurate measurement done on both so you and they need to try again.
And to help measure for damage you need visual field tests, usually an OCT scan of the nerve head and retina and for a complete glaucoma exam you should have a mirror lens placed on your eye to check the depth of the front of the eye to see if you need laser (like one poster above has had).
Also when you've had a PI you should absolutely be fine to dilate and your optom will do you a disservice if they miss a retinal problem for the extremely low chance of spiking your pressure.
redhotsheep said:
Also when you've had a PI you should absolutely be fine to dilate and your optom will do you a disservice if they miss a retinal problem for the extremely low chance of spiking your pressure.
Highest pressure I’ve ever measured was in a patient who had been give cyclopentolate to dilate her eyes by eye casualty. Reading was 98 and wouldn’t go down until we arranged a paracentesis.She was in absolute agony... Her existing PIs didn't prevent this from happening
Edited by randytusk on Saturday 30th July 21:10
randytusk said:
Highest pressure I’ve ever measured was in a patient who had been give cyclopentolate to dilate her eyes by eye casualty. Reading was 98 and wouldn’t go down until we arranged a paracentesis.
She was in absolute agony….
Ok? Shall we list the numbers of patients with PIs that get dilated with no issue? Hence why I said 'should' and 'extremely low chance'. Medicine doesn't work on anecdotes as you know.She was in absolute agony….
I had an iridotomy in both eyes last year due to high pressures and the risk of narrow angle glaucoma. Initially spotted during a regular eye test, they issued a referral to the local eye unit. I never had any symtpoms (eye pain etc).
Narrow angle glaucoma is caused by the fluid around the eye not being able to seep away, this casues pressure to build and pushes on the optic nerve, Between appointments I was warned just go straight to A&E if I experienced any sight loss or pain Yes, it can be quite serous if left untreated.
The iridotomy solves the problem by making a hole through the iris with a laser, thus allowing the fluid an escape and thus pressure is relieved.
The procedure doesn't take long (10-15 mins), done one eye at a time I wouldn't say its painful (anesthetic is applied to the eye), but the laser zaps feel like someone just twanged an elastic band inside the bakc of your head. Afterwards its disconcerting because it looks like its night time to the treated eye, pitch black at first its like dawn breaking as the light sensitivity returns to normal, I was pretty much back to normal after a few hours. Had a course of drops to use for some time after (IIRC 6 times a day initially!) but after that no need for medication.
Narrow angle glaucoma is caused by the fluid around the eye not being able to seep away, this casues pressure to build and pushes on the optic nerve, Between appointments I was warned just go straight to A&E if I experienced any sight loss or pain Yes, it can be quite serous if left untreated.
The iridotomy solves the problem by making a hole through the iris with a laser, thus allowing the fluid an escape and thus pressure is relieved.
The procedure doesn't take long (10-15 mins), done one eye at a time I wouldn't say its painful (anesthetic is applied to the eye), but the laser zaps feel like someone just twanged an elastic band inside the bakc of your head. Afterwards its disconcerting because it looks like its night time to the treated eye, pitch black at first its like dawn breaking as the light sensitivity returns to normal, I was pretty much back to normal after a few hours. Had a course of drops to use for some time after (IIRC 6 times a day initially!) but after that no need for medication.
I'm not a clinician, so I just go by the advice of mine. She states that there is a degree of risk in dilating my eyes, so she avoids that procedure.
She seems able to examine my retinas and optic nerves, using a hand held prism and an excruciatingly bright white light.
I attend for a follow-up exam every 6 months - to check that my pressures are stable and that my iridotomy apertures are still good (apparently in some people there is a tendency for the holes to close-up over time).
I also have a periphery field test annually and to date have no issues there either.
She seems able to examine my retinas and optic nerves, using a hand held prism and an excruciatingly bright white light.
I attend for a follow-up exam every 6 months - to check that my pressures are stable and that my iridotomy apertures are still good (apparently in some people there is a tendency for the holes to close-up over time).
I also have a periphery field test annually and to date have no issues there either.
audi321 said:
Hi all, any opticians out there who can advise?
I'll start by saying I always seem to have high pressure in my eyes when I have an eye test. One optician once put it down to tensing up so much when getting ready for the puff of air! One optician even referred me to the eye hospital some 15 years ago but I was sent home without issue.
I have worn glasses for 25 years (not strong -1.5).
However, today I thought I'd have a free consultation for laser eye surgery. The consultant didn't use a puff of air, he used a blue light (which basically was touching my eyeball) and he said was better than the puff of air. I could feel myself tensing up worse than the puff of air! Result is a reading of 36 in one eye and he couldn't get a reading in the other.
He's refusing to discuss laser eye surgery and wants to discuss gloucoma management. Has put me on drops (Xalatan?).
How worried should I be? He said it should be below 20. Is there another test they can do for gloucoma rather than these? I have incredibily sensitive eyes anyways, and I just feel these tests aren't a proper result due to my inability to relax for the tests.
Thanks all.
HiI'll start by saying I always seem to have high pressure in my eyes when I have an eye test. One optician once put it down to tensing up so much when getting ready for the puff of air! One optician even referred me to the eye hospital some 15 years ago but I was sent home without issue.
I have worn glasses for 25 years (not strong -1.5).
However, today I thought I'd have a free consultation for laser eye surgery. The consultant didn't use a puff of air, he used a blue light (which basically was touching my eyeball) and he said was better than the puff of air. I could feel myself tensing up worse than the puff of air! Result is a reading of 36 in one eye and he couldn't get a reading in the other.
He's refusing to discuss laser eye surgery and wants to discuss gloucoma management. Has put me on drops (Xalatan?).
How worried should I be? He said it should be below 20. Is there another test they can do for gloucoma rather than these? I have incredibily sensitive eyes anyways, and I just feel these tests aren't a proper result due to my inability to relax for the tests.
Thanks all.
Edited by audi321 on Friday 29th July 10:20
I’m a consultant ophthalmologist. It’s a pity he put you straight on drops as there’s a laser procedure called SLT which I do that can lower the pressure more effectively than with the drops and should be the first line of treatment. However, I understand why he put you on drops as he felt the pressure was too high and it probably is. The drops lessen the effect of the laser but the laser can still work and has less long term side effects than the drops.
You need a thorough assessment with a detailed examination of your eye, visual field test and regular follow up. Whereabout are you? I may be able to recommend a consultant local to you.
I have glaucoma in my left eye. My pressures have always been and I'm now on drops. My left eye has gone from early 30's to 19. My right was mid 20's and is now 20.
I can't tell any difference between my left and right eyes but there has been damage to the optic nerve in the left. I'm going on Friday to see a glaucoma specialist after being on the drops for 6 months.
I've cut out caffeine and have increased my leafy vegetable intake as well as taking an eye supplement. Probably all in vain, but I do worry about it. The drops are fine though and I don't have any side affects yet..
I can't tell any difference between my left and right eyes but there has been damage to the optic nerve in the left. I'm going on Friday to see a glaucoma specialist after being on the drops for 6 months.
I've cut out caffeine and have increased my leafy vegetable intake as well as taking an eye supplement. Probably all in vain, but I do worry about it. The drops are fine though and I don't have any side affects yet..
WarnieV6GT said:
I have glaucoma in my left eye. My pressures have always been and I'm now on drops. My left eye has gone from early 30's to 19. My right was mid 20's and is now 20.
I can't tell any difference between my left and right eyes but there has been damage to the optic nerve in the left. I'm going on Friday to see a glaucoma specialist after being on the drops for 6 months.
I've cut out caffeine and have increased my leafy vegetable intake as well as taking an eye supplement. Probably all in vain, but I do worry about it. The drops are fine though and I don't have any side affects yet..
I can't tell any difference between my left and right eyes but there has been damage to the optic nerve in the left. I'm going on Friday to see a glaucoma specialist after being on the drops for 6 months.
I've cut out caffeine and have increased my leafy vegetable intake as well as taking an eye supplement. Probably all in vain, but I do worry about it. The drops are fine though and I don't have any side affects yet..
Ask about SLT laser. Also take ginko biloba supplements. These are the only things that might help glaucoma.
968 said:
audi321 said:
Hi all, any opticians out there who can advise?
I'll start by saying I always seem to have high pressure in my eyes when I have an eye test. One optician once put it down to tensing up so much when getting ready for the puff of air! One optician even referred me to the eye hospital some 15 years ago but I was sent home without issue.
I have worn glasses for 25 years (not strong -1.5).
However, today I thought I'd have a free consultation for laser eye surgery. The consultant didn't use a puff of air, he used a blue light (which basically was touching my eyeball) and he said was better than the puff of air. I could feel myself tensing up worse than the puff of air! Result is a reading of 36 in one eye and he couldn't get a reading in the other.
He's refusing to discuss laser eye surgery and wants to discuss gloucoma management. Has put me on drops (Xalatan?).
How worried should I be? He said it should be below 20. Is there another test they can do for gloucoma rather than these? I have incredibily sensitive eyes anyways, and I just feel these tests aren't a proper result due to my inability to relax for the tests.
Thanks all.
HiI'll start by saying I always seem to have high pressure in my eyes when I have an eye test. One optician once put it down to tensing up so much when getting ready for the puff of air! One optician even referred me to the eye hospital some 15 years ago but I was sent home without issue.
I have worn glasses for 25 years (not strong -1.5).
However, today I thought I'd have a free consultation for laser eye surgery. The consultant didn't use a puff of air, he used a blue light (which basically was touching my eyeball) and he said was better than the puff of air. I could feel myself tensing up worse than the puff of air! Result is a reading of 36 in one eye and he couldn't get a reading in the other.
He's refusing to discuss laser eye surgery and wants to discuss gloucoma management. Has put me on drops (Xalatan?).
How worried should I be? He said it should be below 20. Is there another test they can do for gloucoma rather than these? I have incredibily sensitive eyes anyways, and I just feel these tests aren't a proper result due to my inability to relax for the tests.
Thanks all.
Edited by audi321 on Friday 29th July 10:20
I’m a consultant ophthalmologist. It’s a pity he put you straight on drops as there’s a laser procedure called SLT which I do that can lower the pressure more effectively than with the drops and should be the first line of treatment. However, I understand why he put you on drops as he felt the pressure was too high and it probably is. The drops lessen the effect of the laser but the laser can still work and has less long term side effects than the drops.
You need a thorough assessment with a detailed examination of your eye, visual field test and regular follow up. Whereabout are you? I may be able to recommend a consultant local to you.
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