By Daniel Messner, M.D.
Glaucoma Specialist at Carolina Eye Associates, P.A.
Let’s say you go to see your eye doctor for what you expect to be a “routine” eye checkup. Perhaps you wear glasses and your distance vision could be better. Perhaps you are in your mid-40’s and you are having trouble seeing up close or perhaps you have been told you should be checked periodically and it has been awhile.
Whatever the reason, during the course of the exam your eye doctor says that your eye pressure is “a little high” and she wants to dilate your eyes to get a better look at the back of your eye, along with a scan of your retina. Once all of this has been done, your eye doctor tells you she thinks you have “ocular hypertension.” She shows you the scan and pronounces it to be completely normal but recommends another visit in a few weeks for further testing, including a visual field (a peripheral vision test.)
So how concerned should you be? If Ocular Hypertension means high eye pressure, does that mean you have glaucoma? Are you at risk to go blind? After all, you do know that glaucoma can lead to blindness and that it occurs due to high eye pressure.
The term “ocular hypertension” simply means that one’s eye pressure is higher than normal with no detectable damage to one’s optic nerve (the optic nerve transmits visual information from the eye to the brain.) Glaucoma on the other hand implies optic nerve damage has occurred. Left untreated, glaucoma can lead to progressive vision loss, even blindness.
Most cases of ocular hypertension fortunately do not lead to glaucoma, but unfortunately, some do. In practicing medicine, doctors, as much as possible, use clinical trials to guide their decision making. In 2002, an important study was published regarding the treatment of ocular hypertension. This multi-year multi-clinic study showed that treatment of ocular hypertension with pressure reducing eye drops can definitely reduce the possibility of glaucoma developing. Just as important, this study also helps doctors to recognize which patients are at greater risk for glaucoma so that treatment can be given to only patients at greatest risk. These so-called risk factors include optic nerve appearance, visual field testing results, corneal thickness, pressure over 25 and age. Family history of glaucoma (especially if significant vision loss has occurred) is also an important risk factor.
Whether treatment is considered appropriate or not, all patients with ocular hypertension should be examined on a regular basis, usually every 6 to 12 months. Visual field testing and optic nerve/retinal scans are done to watch for early signs of damage. With careful follow up and appropriate treatment when indicated, the vast majority of patients with ocular hypertension can be assured that no vision will be lost from glaucoma.
Daniel Messner, M.D. is a Glaucoma Specialist at Carolina Eye Associates, P.A. He has been practicing for over 30 years and sees patients in Fayetteville, Laurinburg, and Southern Pines.