From the Guidelines
Elevated ocular pressure often presents with no noticeable symptoms, but when symptoms do occur, they can include eye pain, headaches, blurred or decreased vision, seeing halos around lights, redness in the eye, nausea, and vomiting in severe cases. According to the primary open-angle glaucoma preferred practice pattern 1, established risk factors for primary open-angle glaucoma (POAG) include older age, African race or Latino/Hispanic ethnicity, elevated intraocular pressure (IOP), family history of glaucoma, low ocular perfusion pressure, type 2 diabetes mellitus, myopia, and thin central cornea. Some people may experience a feeling of pressure or fullness in the affected eye. However, it's essential to note that early elevated ocular pressure frequently has no noticeable symptoms, which is why it's called the "silent thief of sight."
Regular eye examinations are crucial for early detection, as untreated high eye pressure can lead to glaucoma and permanent vision loss. The primary open-angle glaucoma suspect preferred practice pattern 1 also highlights the importance of monitoring patients with elevated IOP, as treatment to lower IOP can reduce the risk of developing POAG. If you experience any symptoms, especially sudden eye pain with nausea or vision changes, seek immediate medical attention, as the pressure inside the eye is maintained by a balance between fluid production and drainage; when this balance is disrupted, pressure increases and can damage the optic nerve over time, leading to irreversible vision loss if not properly managed. Key points to consider include:
- Elevated IOP is a significant risk factor for POAG
- Regular eye examinations are crucial for early detection
- Treatment to lower IOP can reduce the risk of developing POAG
- Monitoring patients with elevated IOP is essential to prevent vision loss.
From the Research
Symptoms of Elevated Ocular Pressure
Elevated ocular pressure is a major risk factor for glaucoma, a condition that can lead to vision loss if left untreated. The symptoms of elevated ocular pressure may not always be apparent, but they can include:
- Blurred vision
- Eye pain
- Headaches
- Nausea and vomiting
- Rainbows or halos around lights
Treatment Options
Treatment for elevated ocular pressure typically involves the use of medications to lower intraocular pressure (IOP). The following are some of the treatment options available:
- Prostaglandin analogues (PGAs) 2
- Beta-blockers (BBs) 3, 2
- Carbonic anhydrase inhibitors (CAIs) 4, 3, 2
- Alpha-adrenergic agonists 3, 2
- Combination therapy, such as PGAs and BBs 2, 5
Mechanisms of Action
The mechanisms of action of these treatment options vary, but they all work to reduce IOP by:
- Reducing aqueous humor production
- Increasing aqueous outflow
- Reducing fibrosis in the trabecular meshwork 5
Efficacy and Safety
The efficacy and safety of these treatment options have been studied in various clinical trials. The results show that:
- PGAs are effective in lowering IOP, but may cause hyperaemia and ocular discomfort 2
- BBs are less effective than PGAs in lowering IOP, but may have fewer side effects 2
- CAIs are effective in lowering IOP, but may cause systemic side effects 4, 3
- Combination therapy, such as PGAs and BBs, may be more effective than monotherapy in lowering IOP and reducing fibrosis in the trabecular meshwork 2, 5