What is Ocular Hypertension?
What are the Symptoms of Ocular Hypertension?
- Pain around the head and eyes
- Temporary blurred vision
- Pain when touching the eye
- Painful red eyes
What Causes Ocular Hypertension?
- Being over 40 years old,
- Diabetes,
- Myopia,
- A family history of ocular hypertension,
- Long-term corticosteroid treatments,
- Eye injuries are known causes.
Who is More Likely to Develop Ocular Hypertension?
Ocular hypertension, or glaucoma, can occur at any age, but the risk is much higher in some individuals. The likelihood of glaucoma is significantly increased, particularly in individuals over the age of 40. Those with a family history of glaucoma should have more frequent eye examinations due to their genetic predisposition to this condition. Additionally, individuals with chronic diseases such as diabetes, hypertension, and myopia are at higher risk for developing ocular hypertension.
Long-term use of corticosteroids, trauma to the eye, and some eye surgeries can also set the stage for glaucoma. Individuals with smaller eye structures, known as hypermetropes, have a higher risk of closed-angle glaucoma. It is recommended that individuals in the risk group undergo detailed eye examinations at least once a year. Through these checks, glaucoma can be detected at an early stage and controlled before it progresses.
How is Ocular Hypertension Diagnosed?
How is Ocular Hypertension Monitored?
Given that ocular hypertension is a progressive condition, monitoring is crucial. Eventually, consecutive computerized visual field and OCT tests can determine the rate of disease progression. Treatment of ocular hypertension without determining the rate of progression may unfortunately be inadequate.
How is Ocular Hypertension Treated?
- Medication Therapy: There are many drops used in the treatment of ocular hypertension with medication. These drops reduce intraocular pressure through different mechanisms of action. They are used regularly and lifelong at specified intervals. If initial treatment is not successful, a second drop is added. If intraocular pressure still does not decrease, according to the treating doctor's opinion, a third drop is added, or other treatment methods are employed.
- Laser Treatment: In patients who do not respond adequately to medication therapy for ocular hypertension, laser treatment may be applied.
- Surgical Treatment: In surgery, a small channel is opened in the white part of the eye. This channel, which is too small to be visible from the outside, facilitates the drainage of the high-pressure fluid inside the eye. Thanks to advancing technology and new methods, surgeries can be performed to either reduce ocular hypertension without using any stitches or to remove the fluid inside the eye with the help of a tube in advanced cases.
Laser and Surgical Methods in Ocular Hypertension Treatment
When ocular hypertension cannot be controlled with medication, laser treatments can come into play. One of the most commonly applied methods is called laser trabeculoplasty. This procedure allows for the regulation of the eye's drainage system to facilitate the outward flow of intraocular fluid. The application is brief and generally painless. It can be performed in a clinical setting, and the patient can be discharged the same day.
If laser treatment is inadequate or the damage to the optic nerve has progressed, surgical methods are considered. In glaucoma surgery, a new channel is created to allow for the controlled drainage of intraocular fluid. This procedure reduces intraocular pressure and relieves pressure on the nerve tissue. The recovery process after surgery can take several weeks, requiring follow-up under a doctor's supervision.
In some cases, minimally invasive methods such as intraocular micro stents may also be preferred. These next-generation treatments are more comfortable and entail lower risks of complications compared to classical surgery. The treatment method is determined by the physician based on the patient's overall condition, the type of glaucoma, and the structure of the eye.
Risks of Untreated Glaucoma
If glaucoma is not treated, it can lead to irreversible vision loss. Damage to the optic nerve over time disrupts both central and peripheral vision. Initially, peripheral vision is affected, and over time, central vision may decrease as well. This process progresses slowly, which is why most people do not notice the disease until it reaches its final stage.
In advanced stages, night vision decreases, sensitivity to light increases, and clarity of vision is lost in dark environments. This significantly affects the quality of life. Blindness due to glaucoma ranks among the leading causes of preventable vision loss worldwide. With regular monitoring and proper treatment, this process can be completely halted or at least slowed down. Therefore, it is vitally important for glaucoma patients not to neglect their treatments.
What is the Role of Visual Field and OCT Testing in Glaucoma Monitoring?
Visual field testing and OCT (optical coherence tomography) are two important diagnostic and monitoring methods in managing ocular hypertension. The visual field test measures how much area the patient can clearly see. In this test, peripheral vision is usually affected first. Therefore, glaucoma damage that initially goes unnoticed can be easily detected with this test.
The OCT device measures the thickness of the retina and optic nerve head at the micron level, providing a numerical indication of glaucoma's impact on nerve tissue. Measurements taken before and after treatment offer a clear means of tracking the progression of the disease. Even if ocular hypertension is brought under control, nerve damage may continue. Hence, these tests are critically important in glaucoma management.
Frequently Asked Questions
What is Ocular Hypertension?
Ocular hypertension is a chronic eye condition that develops as a result of damage to the optic nerve caused by an increase in pressure created by the accumulation of fluid inside the eye. When the balance between the production and drainage of intraocular fluid is disrupted, the pressure increases, and this condition begins to damage the optical nerve cells. This nerve damage can lead to progressive vision loss. The disease usually presents no symptoms and can result in serious vision problems if detected late.
What are the Symptoms of Ocular Hypertension?
Ocular hypertension often shows no symptoms in its early stages. Therefore, regular check-ups are essential. When symptoms do appear, they generally include the following:
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Halos around lights
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Sensation of pressure behind or around the eye
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Narrowing of the field of view
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Blurred vision, more pronounced in the mornings
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Headaches, nausea (in acute types)
If one or more of these symptoms are noticed, an ophthalmologist should be consulted without delay.
What Causes Ocular Hypertension?
Ocular hypertension occurs due to the accumulation of fluid inside the eye that cannot be drained properly. This accumulation turns into pressure, eventually placing stress on the optic nerve. The causes of ocular hypertension include genetic factors, age, systemic diseases, long-term use of corticosteroids, migraines, low blood pressure, and other factors. Eye injuries can also sometimes cause a sudden increase in intraocular pressure.
What Should the Intraocular Pressure Be?
Normal intraocular pressure is considered to be between 10 and 21 mmHg. However, these limits can vary from person to person. While a pressure of 23 mmHg may not cause issues for some individuals, it may lead to glaucoma in others with a pressure of 17 mmHg. Therefore, diagnosis is not based solely on intraocular pressure measurement. The condition of the optic nerve, visual field testing, and retinal analysis also play important roles in the diagnosis of ocular hypertension.
How to Lower Ocular Hypertension at Home?
Some supportive measures to help balance ocular hypertension at home include:
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Limiting caffeine intake
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Engaging in regular daily walks or light exercise
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Avoiding stress
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Getting adequate and quality sleep
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Avoid sleeping face down, keeping the head slightly elevated
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Reducing salt intake and spreading fluid consumption throughout the day
However, these practices are not curative. Ocular hypertension must be controlled with medication therapy or surgical planning under a doctor's supervision.
How Does Ocular Hypertension Decrease?
The most common method to lower ocular hypertension is medication. Eye drops are generally the first preferred treatment method. These drops help reduce the production of intraocular fluid or increase its drainage. In some cases, oral medications may also be added. Laser treatment can be applied if necessary, targeting a reduction in intraocular pressure. In advanced cases, surgical interventions may become inevitable. A personalized treatment method should be determined for each patient.