Ocular Hypertension

By on September 3, 2012 with No Comments

Ocular Hypertension is a condition in which the pressure inside the eye, which is also known as intraocular pressure, is more than the normal range. The normal eye pressure is measured somewhere between 10 and 21 mmHg. However when this pressure is more than 21 mmHg, then a patient may be diagnosed of having ocular hypertension. The condition may affect one or both eyes and in several occasions.

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In ocular hypertension, the optic nerve is normal and may not have problems. A patient with this disorder has no signs of glaucoma and there are no signs of other ocular diseases. Statistics have shown that about 3-6 million people in US have intraocular pressure which is greater than 21 mmHg with no detectable signs of glaucoma.

This does not mean that these people have developed ocular hypertension but they are considered to be at risks of acquiring the condition. Ophthalmologists have argued that ocular hypertension may not be considered a disease by itself but rather a condition, which require close examination and monitoring to rule out possible onset and development of glaucoma. This is the reason why people with this condition or higher intraocular pressure have been referred to as glaucoma suspects.

What are the causes of ocular hypertension ?

One of the main risk factors of increased intraocular pressure is glaucoma. This means that people with elevated intraocular pressure or pressure inside the eye are likely to suffer from glaucoma. When there is an imbalance in the synthesis and drainage of fluid (aqueous humor) in the eye, this can create high pressure inside the eye.

This may occur if the channels that drain off the fluid from the eye are malfunctioning. In this situation, there is more fluid or aqueous humor being produced but it is not being drained from the eye. This eventually leads to increased fluid inside the eye and thus a pressure is created.

Pathophysiology of ocular hypertension

The pressure within the eye or intraocular pressure is maintained by a liquid know as aqueous humor and this is synthesized by ciliary body of the eye. The liquid stays only in the anterior part of the eye and does not go into the posterior segment. The lens and the Zonule of Zinn bar the fluid from going to the posterior part of the eye.

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In the eye, there are anterior and posterior chambers, which are both found in the anterior segment. This aspect is very important when examining how intraocular pressure occurs. When the aqueous fluid is produced by ciliary, it first moves to the posterior chamber, which is bounded by the iris and the lens.

It then flows past the pupils of the iris and enters the anterior chamber. From the anterior chamber which is bounded by the cornea and iris, the fluid flows through trabecular network and joins the body circulation system. In essence, ocular hypertension occurs when there is increased production of aqueous fluid or reduced outflow of the fluid.

What are the symptoms of ocular hypertension ?

There are no noticeable signs of ocular hypertension and this is why it is recommended that regular examination of the eye be done by ophthalmologists to establish if a patient has elevated intraocular pressure and rule out any damage of the optic nerve by the increased pressure. However, there are certain things which should compel people to seek for medical attention and get examined of ocular hypertension.

People in the age of 40 years and younger persons should be screened at least after 3-5 years even when there are no signs and symptoms linked to ocular hypertension. Older people who have advanced past the age of 40 years and those of black origin should have screening done more often. If a person has multiple factors that are associated with glaucoma, they should be examined, evaluated and monitored frequently.

Treatment of ocular hypertension

There are medications which are applied in countering ocular hypertension and these are aimed at reducing the intraocular pressure. It is essential that the medication be followed as prescribed by the doctor in order to avoid damage of the optic nerve and acquiring of permanent vision loss like glaucoma.

Some of the medications used in treating ocular hypertension are pilocarpine, acetazolamide, timolol and clonidine. There are also less common medications used such as medicinal cannabis. In addition, eye drops may be applied initially in the eyes. Early treatment of ocular hypertension helps prevent the risk of developing vision loss like glaucoma.

Glaucoma is a common cause of blindness. High pressure inside the eye which is termed as intraocular pressure is a major cause of primary open angle glaucoma. Studies show that about 4-7% of the US population, which is above 40 has ocular hypertension (intraocular pressures of 21 mm Hg or higher) without signs of glaucoma. This is a group of people who are at a higher risk of developing glaucoma which leads to total blindness.

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