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Ocular Hypertension and Glaucoma

Published on Nov 18, 2015

Everyone needs a certain level of eye pressure to see and have normal eye function. The proper pressure comes from a balanced amount of fluid in the eye. It is a natural phenomenon called “intraocular pressure,” or IOP. However, in some people, the pressure becomes too high which can cause damage to the optic nerve and lead to glaucoma, a serious and progressive eye disease.

Sometimes IOP can rise to levels that may be potentially unhealthy (sometimes called “ocular hypertension”). Although IOP is one of the factors to consider in making the diagnosis of glaucoma, there are other factors that go into diagnosing and determining appropriate treatment. An accurate diagnosis is important because high IOP is a significant risk factor for the development of glaucoma, and treatment can help prevent or delay the onset of disease. Note that high IOP alone does not cause glaucoma.

Factors that determine if higher than average IOP levels are harmful may include the following:

  • Whether you’re near-sighted (myopic).
  • Whether you have a family history of glaucoma.
  • Your ethnicity (e.g., African-Americans, Latinos and Asians are at higher risk).
  • The thickness of your cornea (e.g., a thin cornea is a risk).

Additionally, if you are over the age of 60 and have not had your eyes examined including the measurement of your IOP, it is important to do so.

If you have IOP levels that are higher than normal, your eye doctor may discuss the possible additional risk factors with you that will help to determine if you should be treated or watched with repeated examinations. If an eye doctor says your IOP is high enough to consider a diagnosis of glaucoma, a second opinion is often recommended from an eye doctor who specializes in glaucoma. It may take an experienced specialist to determine what might be a normal pressure for you versus what may be too high.

What may be considered high IOP in one person may not be considered high in another—this is based on several factors including one’s ethnicity and whether damage is already present. Sometimes people with an IOP that is not considered elevated can develop glaucoma.

Treating High IOP

Treatment for high eye pressure is important because high IOP may cause damage to your optic nerve and limit your field of vision. The optic nerve, which is located in the back of the eye, transmits what you see with your eyes to the brain.

The primary treatment for high IOP is the use of prescription eye drops which work to lower the IOP. The goal is to lower IOP to a level where damage to the optic nerve is slowed or halted. This will preserve the field of vision and slow the progression of glaucoma.

What You Can Do

There are different eye drops that can control your eye pressure through a number of different mechanisms of action. Some people take more than one type of eye drop every day. If you are using eye drops for high IOP, make sure that you use them exactly as prescribed by your doctor. The colored bottle caps that are sometimes dispensed by the pharmacist can make it easier to identify different eye drop medications.

Even with the help of colored bottle caps, the average person with high IOP uses their eye drops only 70% of the time. The following tips can help you remember to take your eye drops correctly:

  • Link the time you take your eye drops to something else you always do (e.g., eating breakfast, lunch or dinner).
  • Set a reminder on an alarm clock, smart phone, or wrist watch, or mark a calendar when drops are taken each day.
  • Ask a spouse or family member to remind or assist you every day.
  • Bring your drops with you when away from home, even if it’s just for the day.
  • Keep your eye drop bottles on a counter or out in the open where you can clearly see them.
  • Have a written medication schedule listing all of your eye drops (including the other medications you are taking) so you know when to administer (or take) them.

Many people are successful at managing IOP and slowing the progression of glaucoma. It is key to keep your eye pressure at levels to help prevent further harm to the optic nerve. So get organized and be sure to take your eye drops as prescribed.

Charles Tressler, M.D. is an ophthalmologist and a Senior Director in Worldwide Safety and Regulatory at Pfizer Inc.

[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]


  • 1. American Glaucoma Society. Position statement on color coded caps for glaucoma drops. Accessed June 18, 2015.
  • 2. US Department of Health and Human Services. Medicines and you: a guide for older adults. Accessed June 18, 2015.
  • 3. Glaucoma Research Foundation. Eye Anatomy. Accessed June 18, 2015.
  • 4. Glaucoma Research Foundation. Glaucoma Medications and Their Side Effects. Accessed June 18, 2015.
  • 5. Glaucoma Research Foundation. High eye pressure and glaucoma. Accessed June 18, 2015.
  • 6. Hispanic Americans and Latinos at increased risk. Accessed June 18, 2015.
  • 7. Glaucoma Research Foundation. How glaucoma affects the optic nerve. Accessed June 18, 2015.
  • 8. Glaucoma Research Foundation. Ocular Hypertension Treatment. Accessed June 18, 2015.
  • 9. John Hopkins Medicine. How to succeed at eye drops: it’s all in your hands. Accessed June 18, 2015.
  • 10. Law S. First-line treatment for elevated intraocular pressure (IOP) associated with open-angle glaucoma or ocular hypertensions: focus on bimatoprost. Accessed June 18, 2015.
  • 11. National Eye Institute. What you should know. Accessed June 18, 2015.
  • 12. Noecker R. The management of glaucoma and intraocular hypertension: current approaches and recent advances. Ther Clin Risk Manag. 2006 Jun; 2(2): 193-206.
  • 13. The Glaucoma Foundation. A second opinion may be helpful. Accessed June 18, 2015.
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