Why having a person’s eye pressure checked is important for their eye health
The fluid inside a person’s eyes has a lot to do with overall eye health. Here’s why.
Eye pressure may not be something a person thinks about all that often. That’s because people can’t “see” eye pressure when they look in the mirror.
But when a person goes to see their eye care provider, it may be a different story. They may test a person’s eye pressure, which is vital part of their eye health and how well their eyes work.1
If a person’s eye pressure is too high or too low, it may indicate a concern for their overall eye health, such as glaucoma or other eye diseases that may lead to vision loss. The scary part: If a person’s eye pressure is high or low, they may not even feel it.1
“There are thousands of people who have glaucoma, and their vision is being eaten away and they don’t know it until it’s too late,” says Chris Lievens, O.D., director of research at Southern College of Optometry.
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What is eye pressure, exactly?
Eye pressure, also known as intraocular pressure, refers to the pressure of fluid inside a person’s eye. Each person may have a different eye pressure.2
There may be 2 types of fluid in the eye:1
- Aqueous humor is a thinner, watery fluid at the front of the eye, which fills the space between the cornea (the clear outer layer of the eye) and the iris (the part of the eye that has color).
- Vitreous humor is a thicker, gel-like fluid that’s produced in a chamber at the back of the eye.
A person’s body tends to regulate its own eye pressure. As Dr. Lievens puts it: “The fluid on the front of the eye has a faucet and a drain.” So, as the body creates more aqueous humor, an equal amount may drain out of the eye.
If a person’s eye pressure is too high, it could mean that their faucet-drain system isn’t working correctly. It may also cause damage to the eye.
How might an eye care provider test a person’s eye pressure?
Eye pressure is “something that can change abruptly,” says Dr. Lievens. So, it’s something that eye care providers tend to check in every patient at every visit, he adds.
The best way for a person to check their eye pressure may be to book a comprehensive eye exam with their eye care provider. An eye care provider may do several types of tests to check eye pressure.
The eye pressure test, known as tonometry, may be done with a device called a tonometer. The test flattens the cornea slightly. The amount it may flatten and how it may rebound indicates how much pressure there may be inside the eye.
The most common type is noncontact tonometry, sometimes called an air-puff test. During the test, a device shoots out a puff of air that flattens a person’s cornea. Another type of eye pressure test is called applanation tonometry, or Goldmann tonometry. It’s known as the gold standard of eye pressure tests because it’s extremely accurate. An eye care provider may numb the surface of the eye with drops and may use a small slip of paper to introduce an orange dye to the eye.3, 4
The eye care provider may gently place a small probe onto the cornea. A person may see the blue light of the lamp used in the test but likely won’t feel anything touch their eye. “Many patients don’t know we’re checking,” says Dr. Lievens.
A person’s eye care provider may determine the most appropriate method based on a person’s individual needs and medical history. Whatever the method, it’s a good idea for a person to get their eye pressure measured yearly, at minimum, notes Dr. Lievens. “And that’s for a healthy person with no other risk factors.”
What might happen if a person’s eye pressure is too high?
Since a person can’t feel or see their eye pressure, it may be important for them to get an eye exam to get it tested. It’s even more important because of what abnormal eye pressure may do to a person’s eyes.
If a person has abnormal eye pressure, it may lead to conditions such as:
Glaucoma. “The most common condition in which intraocular pressure is abnormal is glaucoma,” says Dr. Lievens. Glaucoma is a disease that may damage your optic nerve — and even lead to blindness.5 If a person has glaucoma, pressure may build up in the aqueous humor and put pressure on the optic nerve.
Glaucoma is the leading cause of blindness in people over 60, according to the American Academy of Ophthalmology.5 Early treatment for glaucoma, however, may help save a person’s eyesight — although it can’t undo any damage that’s already been done.
Ocular hypertension. A person may experience this condition, in which their eye pressure is too high, but their optic nerve may appear normal. Plus, they might not experience vision loss with it. In this case, the eye care provider may tell the person that they may be at higher risk of glaucoma.5
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Who might be at highest risk of having high eye pressure?
A person’s eye pressure may change a lot during a 24-hour period. Even doing things like lying down to sleep at night might increase a person’s eye pressure, says Dr. Lievens. “There are a lot of folks we falsely assume are OK, but unbeknownst to us at 3 in the morning, it is very high,” he says.
Those who may be at higher risk of having high eye pressure could include:5, 6
- People over the age of 40
- People taking long-term steroids
- People who are Black and Hispanic
- People who are very nearsighted
- People who have a family history of glaucoma, diabetes or high blood pressure
- People who have frequent migraine headaches
- People who have had eye surgeries or injuries, such as being hit in the eye with a ball
- People with certain medical conditions, such as pigment dispersion syndrome (a type of glaucoma) and pseudoexfoliation syndrome (when tiny dandruff-like flakes build up on the body)
A person may want to schedule an appointment to get an eye pressure test if they experience:5
- Blurred visions
- Halos around lights
- Persistent or severe eye pain
- Problems with peripheral (side) vision
- Tunnel vision
How might an eye care provider treat high eye pressure?
The goal of treatment may be to decrease a person’s eye pressure before it may damage their vision. Loss of vision due to glaucoma cannot be reversed.
But eye care providers may have several treatments at their fingertips. These could include:5
- Eye drops. Special medicated eye drops may be used to control eye pressure issues caused by glaucoma. They do that by either reducing the amount of aqueous humor the eye produces or helping fluid drain more easily. A person may use the drops in the affected eye or both eyes.
- Laser surgery. This may ease eye pressure by widening or creating an opening to allow for draining of fluid more easily. It may be performed in an eye care provider’s office.
- Eye surgery. This would most likely be performed in an operating room. The surgery would help allow the eye fluid to drain. It could include inserting a drainage tube or making a flap in the white of the eye, called the sclera. In those cases, the fluid may be redirected and reabsorbed by the body.
- Cataract surgery. This is when the natural lens of the eye is removed. Cataract surgery might be performed to lower eye pressure for people with a certain type of glaucoma called narrow-angle glaucoma. The surgery would provide more space for the fluid to leave the eye.
How might a person maintain healthy eye pressure?
Some factors affecting eye pressure, such as age and family history, may be beyond a person’s control. But there may be steps they may take to promote healthy eye pressure and overall eye health:7
- Follow eye treatment recommendations from an eye care provider
- Understand family’s eye health history
- Get regular eye exams
- Maintain a healthy lifestyle
- Report eye pain or changes in vision to an eye care provider right away
- Stick with medications that treat related conditions such as high blood pressure and diabetes
- Use eye protection when playing sports or activities that may put the eyes at risk
Dr. Lievens notes that getting an eye pressure test may be a great first step. “It’s such an easy test,” he says. If high eye pressure and glaucoma may be caught early, they may be treated with something as simple as an eye drop. That’s better than the alternative, which may be loss of vision. “I’d rather see patients more often and say you’re doing great,” he says.
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Sources:
- Eye (intraocular) pressure Cleveland Clinic, December 2022.
- Eye pressure testing American Academy of Ophthalmology, April 2022
- Tonometry Cleveland Clinic, May 2022.
- Fluorescein eye stain National Library of Medicine: MedlinePlus, February 2023.
- What is glaucoma? Symptoms, causes, diagnosis, treatment American Academy of Ophthalmology, December 2023.
- What is ocular hypertension? American Academy of Ophthalmology, May 2023.
- 10 things to do today to prevent vision loss from glaucoma American Academy of Ophthalmology, February 2024.
