1) My ophthalmologist found that I have high eye pressure, is it glaucoma?
No, not necessarily.
First, the blood pressure measurement will have to be repeated later to confirm this increase in ocular pressure.
Then, not all ocular hypertension necessarily means glaucoma. The real glaucomatous disease will be established by the damage to the optic nerve which can be highlighted by various additional examinations such as fundus, Visual Field and OCT or others…
Conversely, there may be normal pressure glaucoma.
2) My ophthalmologist diagnosed me with glaucoma, will I go blind?
No, probably not.
A few decades ago the risk of blindness was real and today glaucoma remains the second leading cause of blindness in the world.
But today, in our latitudes, once diagnosed and treated, it can be treated very well either with eye drops (often taken for life) or with surgery (increasingly rare) or with Selective Laser which today constitutes a new reference treatment for glaucoma.
The real risk of glaucoma is in fact to miss it, to not diagnose it, hence the need, during any simple consultation for glasses in adults, to check the eye pressure.
3) What are the factors that influence eye pressure?
Eye pressure varies depending on many factors. The measurement methods can change it. If the person coming for a consultation is stressed or does not open their eyelids properly, the pressure rises. If they have just drunk one or two cups of coffee or if their tie is too tight, their eye pressure also increases. On the contrary, after a sports session or drinking alcohol, eye pressure will tend to drop. During the day, eye pressure varies cyclically. It is usually higher in the morning and drops in the evening. In glaucoma patients, these variations are even greater and sometimes staggered. Finally, there are seasonal cycles. Depending on the patient, eye pressure is higher in summer or winter. In glaucoma patients, eye pressure can vary even more during the day than in healthy people.
4) What is normal eye pressure?
The average value of eye pressure in the population is 15 mmHg (millimeters of mercury). It is lower in young people (around 10), and tends to rise in older people.
Eye pressure above 21 is considered abnormal and should prompt a search for glaucoma.
However, many people with pressure slightly above 21 mm have no eye disease and need only simple monitoring without treatment.
Conversely, there are patients whose pressure has never exceeded 21 mm and who have glaucoma, called “normal pressure” glaucoma.
In any case, the ocular pressure must be adjusted according to the corneal pachymetry (measurement of the thickness of the cornea). An ocular pressure of 21 in a patient with a large corneal thickness may be normal while the same pressure of 21 with a thin cornea may be pathological.
5) Why does eye pressure vary all the time?
Eye pressure varies depending on many factors. The measurement methods can change it. If the person coming to consult is stressed or does not open the eyelid well, the pressure rises.
If she has just had a cup or two of coffee or if her tie is too tight, her eye pressure also increases.
On the contrary, after a sports session or the ingestion of alcohol, eye pressure will tend to drop.
During the day, eye pressure varies cyclically. It is usually higher in the morning and lower in the evening. Finally, there are seasonal cycles. Depending on the patient, eye pressure is higher in summer or winter.
6) I was found to have high eye pressure, but I have no signs?
Yes, that is often the case.
Ocular hypertension is often asymptomatic, especially when it is less than 25 mmHg.
Only systematic blood pressure measurement by the ophthalmologist during a routine consultation will be able to detect it.
Otherwise, even without symptoms, glaucoma may continue to develop insidiously and cause irreversible damage to the optic nerve.
In case of very high blood pressure (from 30 mm Hg), it is possible to feel headaches, eye pain radiating to the back of the head, to perceive visual fog or colored halos in front of bright lights.
But this is relatively rare.
7) At what time should I put in the drops prescribed for me?
At regular times.
If it is a single daily dose, it does not matter whether it is in the morning or in the evening, the main thing is the regularity of the treatment.
8) I was found to have high eye pressure, yet my blood pressure is low
Yes, this happens often and there is nothing strange about it.
These are two different pathologies, but they may or may not be associated...
9) I have trouble tolerating drops, should I take them for the rest of my life?
If treatment with eye drops is started, it will often (if not always) have to be continued for life.
Selective Laser treatment, a new standard therapy for open-angle glaucoma, can provide an effective solution to avoid it.
10) Is laser effective on glaucoma?
Yes, its effectiveness has been proven in many international studies.
The Argon laser and the Selective SLT laser (which has the advantage of causing no thermal damage) lower blood pressure by around 25%, which is comparable in effectiveness to treatment with eye drops.
After a few years, this hypotensive effect can diminish and you can then have another SLT laser session without any inconvenience due to its total safety.
11) Is the laser dangerous or painful?
Neither dangerous nor painful but sometimes a slight discomfort during the treatment which lasts about 5 minutes and for the 1/2 hour which follows.
12) Is surgery still performed for glaucoma?
Yes, but much less than in the past.
These are glaucomas whose progression cannot be stopped despite maximum drug treatment.
The arrival of Selective laser can be an alternative to surgery to delay or even eliminate the procedure.