Ocular hypertension is when the pressure of fluid in the eye becomes high. This alone may not cause symptoms, but without treatment, it can damage the optic nerve and lead to glaucoma.

Ocular hypertension and other eye conditions can cause lasting vision problems, which is why it is essential to have regular eye exams. An ophthalmologist or optometrist can detect any issues with a comprehensive exam and recommend treatment before the issues progress.

This article looks at ocular hypertension and its connection to glaucoma. It also explores the causes, risk factors, and treatments for the condition.

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Ocular hypertension refers to a buildup of pressure in the eye beyond the range that doctors consider normal. This increased pressure does not cause detectable changes in vision.

Usually, a structure toward the middle of the eye, called the ciliary body, produces fluid that flows to the front of the eye before draining away.

Healthy eyes balance fluid production and drainage to maintain a fluid pressure in the normal range. Ocular hypertension results from an imbalance in eye fluids.

Eye doctors measure this pressure in millimeters of mercury (mmHg). Normal eye pressure is typically 10–21 mmHg, and doctors diagnose ocular hypertension when the pressure is higher.

In addition, the following criteria need to be true before a doctor diagnoses ocular hypertension:

  • The optic nerve, which connects the eyes and brain, is healthy.
  • There is no vision loss.
  • There are no other causes of the increase in pressure, such as glaucoma, an eye condition that can cause vision loss.

Ocular hypertension and glaucoma are related but not the same. In a person with ocular hypertension, the optic nerve, which relays visual information to the brain, is unaffected, and the person’s vision is normal.

People with ocular hypertension have a greater chance of developing glaucoma, however, because the increased eye pressure can damage the optic nerve over time.

Glaucoma is the second leading cause of blindness, and it results from a damaged optic nerve, often due to ocular hypertension.

People with ocular hypertension usually have no symptoms.

This is one reason why it is important to have regular eye checkups. These allow an optometrist or ophthalmologist to check for ocular hypertension. If the pressure within the eye is increased, the eye doctor then assesses for glaucoma.

Anyone can develop ocular hypertension, but some people have an increased risk. Some risk factors include:

  • an increase in the eye’s fluid production
  • inadequate drainage in the eye
  • certain medications, such as steroids
  • eye trauma

In addition, the American Academy of Opthamology reports that African American and Hispanic people have an increased risk of ocular hypertension, but it does not describe the reasons for this.

Ophthalmologists and optometrists are doctors who specialize in diagnosing and treating eye conditions. They can perform various tests to check for ocular hypertension.

One test is called gonioscopy, and it involves using a contact lens to look at the drainage channels in the eyes to assess whether their angles are open, narrow, or closed. This can affect how well they drain fluid.

Eye doctors may also measure eye pressure using a tool called a tonometer. First, the doctor administers numbing drops, then they look at how the cornea resists pressure. The cornea is the transparent outer layer at the front of the eye.

To distinguish between ocular hypertension and glaucoma, the eye doctor may use visual field testing and optical coherence tomography. Visual field testing helps the doctor check the distance of vision in the eye without its moving, and optical coherence tomography produces an image of the back of the eye — the retina.

Treating increased pressure within the eye is crucial to prevent damage and vision loss. If a person has ocular hypertension, their eye doctor should also test their eye pressure regularly.

When the pressure increase is minimal, regular monitoring may be sufficient. For other people with the condition, doctors may also recommend eye drops or laser treatment.

Topical eye treatments

These prescription eye drops reduce pressure in the eye either by helping fluid drain or limiting its production.

For many people, these drops successfully limits eye pressure and reduces the chances of developing glaucoma by 50%.

However, this medication can cause side effects and it may not be effective. Sometimes, the treatment is not effective because a person does not administer the drops regularly enough.

Laser treatment

Selective laser trabeculoplasty (SLT) is another option for people with ocular hypertension. The procedure decreases eye pressure by allowing for greater fluid drainage. It is usually painless and has a short recovery time.

SLT reduces eye pressure by about 30%, which is comparable to the effects of the most potent medications. The effect of the procedure lasts at least 1–5 years. A person can have repeated procedures, though these are often not as effective as the initial procedure.

Some people receive both laser treatment and medication.

People with ocular hypertension have an increased risk of developing glaucoma.

A 2021 study looked at outcomes of people with ocular hypertension 20 years after their diagnoses. It found that roughly 42% of people using medication developed the most common type of glaucoma, compared with 49% of people who did not receive treatment but went for regular monitoring.

Across both groups, 25% of people experienced some vision loss.

Ocular hypertension refers to increased pressure in the eye. It may not cause symptoms, but treating it is crucial for preventing damage to the optic nerve that can result in glaucoma and vision loss.

The treatment may only involve having regular eye exams to monitor the condition. Or, the doctor may recommend prescription eye drops or laser treatments.