Is it possible to cure eye pressure? Tests to detect changes in eye pressure

Update: November 2018

Intraocular pressure (IOP) helps maintain the round shape of our eyes. Its norm is maintained at the level 10 – 21 mm r.s.. If this figure is higher, they speak of ocular hypertension. Read more about the symptoms of high eye pressure and its treatment.

Types of high IOP

For reasons:

• Symptomatic or secondary eye pressure occurs against the background of various diseases - hypertension, diabetes mellitus, thyroid dysfunction, certain eye diseases, and taking medications.
• Essential or primary. It occurs in people over 40 years of age due to age-related changes and impaired outflow of intraocular fluid.

According to the degree of impact on the structures of the eye:

• Ophthalmohypertension. Only high blood pressure is noted, often asymptomatic; no changes in the fundus are observed. Risk of developing glaucoma.
• Glaucoma. This is a more severe degree of ocular hypertension with irreversible changes in the optic nerve head, with impaired visual acuity and loss of visual fields.

By time:

• Permanent.
• Episodic. This may include a short-term increase in intraocular pressure in healthy people due to stress, physical strain, and excess fluid intake.

By localization:

• One-sided.
• Two-way.

By degree of increase

• Normal – up to 21 mm r.s.
• Moderately increased - up to 28 mm r.s.
• High – above 28 mm r.s.

Why is it rising?

• Excessively high production of intraocular fluid (after wounds of the eyeball, antiglaucomatous operations)
• Poor drainage from the anterior chamber (ciliary body degeneration, inflammation, blunt trauma to the eye).
• Certain medications (long-term use of steroid hormones).
• Eye injuries.
• Significant reduction in blood pressure (blood pressure).
• Other eye diseases (sluggish uveitis of any etiology).
• Diabetic coma.

Measurement methods

Measuring eye pressure (tonometry) is mandatory during a preventive examination by an ophthalmologist for individuals starting at the age of 40 years.

There are many tonometry methods. But in clinical practice, indirect methods are used. The basic principle of such measurements is to determine the response of the eye to a force applied to it.

An experienced doctor can evaluate it without instruments - by the resistance of the eyeball when pressing on it with fingers.

But the two methods most often used are:

Tonometry according to Maklakov

It is based on measuring the degree of flattening of the cornea when a weight weighing 10 g is placed on it. The method is simple, quite reliable, and is used both for preventive examinations and for monitoring treatment in glaucoma patients. When measuring intraocular pressure in this way, they speak of tonometric pressure, and the normal values ​​are slightly higher (a figure of up to 25 mm r.s. is considered normal).

Non-contact tonometry

This is a measurement of the flattening of the cornea when it is exposed to a stream of compressed air. The method is less reliable, but quite suitable for the primary detection of high IOP.

Low IOP

In addition to high pressure, low eye pressure (ocular hypotension) may also occur. In this case, intraocular pressure decreases to 7-8 mm p.s. This symptom almost always occurs against the background of other diseases:

• Systemic inflammatory processes affecting the ciliary body.
• After antiglaucoma operations.
• With a sharp decrease in blood pressure.
• Uremic or diabetic coma.
• After eye injury.

Symptoms of ophthalmic hypotension include clouding and folding of the cornea, clouding of the vitreous, and decreased vision. At the same time, the eye decreases in size.

Statistics and norms

The highest IOP is observed in newborns, then gradually decreases up to 10 years. From the age of 20 there is a tendency towards slow growth, and from the age of 70 – towards a decrease.

Norm: 10 – 21 mm r.s. Age differences in the average values ​​of eye tone are very insignificant and usually do not exceed 1.5 mm r.s. Therefore, the norms of eye pressure at 40, 50 years and after 60 years do not differ much.

• The norm of eye pressure in women is slightly higher than in men, no more than 1 mm.
• In summer, IOP is slightly less than in winter, and more in the morning than in the evening.
• Elevated IOP figures are observed in 7.5% of people over 40 years of age,
• After 50 years, this figure reaches 20%.

Symptoms of elevated IOP

Increased eye pressure may not cause symptoms for a long time. You may also experience:

• pressing, bursting pain in the eyes;
• decreased vision that develops gradually;
• the appearance of interference, spots before the eyes;
• rainbow circles when looking at a light source;
• impaired adaptation of the eye to darkness.

Since all these symptoms of eye pressure are nonspecific and develop gradually, a person may not attach importance to them for a long time and not consult a doctor. Thus, pain and swelling in the eyes can be mistaken for fatigue from working with a computer, migraine, hypertension or vasospasm.

But even if there are no signs, long-term untreated ocular hypertension can trigger irreversible changes in the optic nerve.

Glaucoma

Glaucoma is a disease in which high IOP leads to irreversible changes in the optic nerve, vision impairment and blindness. In the initial stages, it is also not always accompanied by symptoms. As the disease progresses, the following may appear:

• pain in one or both eyes;
• decreased visual acuity that cannot be corrected with glasses;
• impaired peripheral vision: a person sees objects in front of him, but may not notice objects from the sides;
• the appearance of spots of “blurriness” in the field of vision;
• Acute attacks of glaucoma may appear - a sharp increase in eye tension, accompanied by pain, decreased vision, eye strain, a fixed pupil, redness of the sclera.

Glaucoma can be open-angle or closed-angle. The names of these forms correspond to the pathogenesis of the disease and the state of the anterior chamber angle. With an open-angle form, the drainage system in this corner is slightly disturbed, so this form can be asymptomatic for a long time. With angle-closure glaucoma, the anterior chamber angle is less than 30 degrees, so its main cause is a violation of the outflow of intraocular fluid.

The most common form is primary open-angle glaucoma.

Main diagnostic criteria for glaucoma:

• Loss of visual fields according to perimetry data.
• Changes in the fundus such as widening or deepening of the excavation of the optic nerve head.
• Persistently high eye pressure and its inherent symptoms are an important, but not the main criterion for glaucoma. Since there are rare forms of glaucoma in which the eye pressure is normal (normotensive).

Untreated glaucoma is the most common cause of total blindness.

The main risk group for glaucoma is people over 60 years of age with hypertension, diabetes mellitus, and those receiving hormonal therapy.

Why is high intraocular pressure dangerous?

Constantly increased IOP is fraught with compression of the optic nerve head, which is located on the retina. As a result of malnutrition, nerve fibers atrophy. First there is a loss of vision in the periphery, and then complete blindness, and irreversible, may occur.

Tactics for detecting increased IOP

A single detection of elevated IOP numbers does not provide grounds for making a diagnosis. It is necessary to remember the physiological factors influencing this indicator.

In addition, pseudohypertension is also distinguished - this is a short-term increase in IOP just before its measurement (nervous tension, fear).

When an increase in IOP is detected for the first time, control measurements are prescribed. Ideally, it is desirable to conduct daily tonometry. This is measuring eye pressure at the same time in the morning and evening for at least three days. Unfavorable criteria are:

• persistent high IOP;
• daily fluctuations in IOP more than 5 units;
• the pressure difference in the right and left eyes is more than 4 units.

It is advisable to carry out daily tonometry in a hospital. It is clear that in practice this is almost impossible. Therefore, measurements are usually prescribed on an outpatient basis several times every other day.

Special contact lenses with IOP sensors have also been developed; they transmit its readings throughout the day to an electronic device.

The ophthalmologist will also advise you to undergo examination by a general practitioner, endocrinologist, or cardiologist to rule out concomitant diseases.

A detected high IOP does not mean the development of glaucoma. In 2/3 of cases of high eye pressure in adults, no other symptoms or changes in the fundus are detected. But doctors classify such patients as at risk for glaucoma and strongly recommend observation and treatment.

Diagnostics

If a persistent increase in IOP is detected, an examination is prescribed to identify glaucoma:

1. Visiometry is the study of visual acuity.
2. Perimetry is the study of peripheral vision.
3. Gonioscopy. This is an examination of the anterior chamber angle using a special mirror lens.
4. Ophthalmoscopy is an examination of the fundus of the eye using an ophthalmoscope.

Treatment

Benign ocular hypertension does not require intensive treatment; observation is recommended. Although many doctors are of the opinion that it is still better to reduce IOP.

If high blood pressure occurs due to other reasons, then eliminating these factors in itself leads to its reduction. For example, withdrawal of steroid hormones leads to complete normalization of IOP within 2 weeks. Mandatory normalization of blood pressure, blood sugar, and thyroid hormones is necessary.

The basic principles of treating eye pressure are as follows:

1. Drug reduction of IOP to the target level (usually 16-18 mm)
2. Treatment of concomitant diseases, elimination of risk factors.
3. If there is no effect from conservative treatment, surgery is performed to improve the outflow of aqueous humor.

The main method of reducing IOP is the use of antihypertensive drops. The principle of action of the drops is to narrow the pupil, open the angle of the anterior chamber of the eye, and also reduce the secretion of fluid. Main groups of drugs:

• Adrenergic blockers (Timolol, Arutimol, Okumed, Timoptic)
• Cholinomimetics (Pilocarpine, Carboholol).
• Carbonic anhydrase inhibitors Dorzolamide (Trusopt, Dorzolamide, Dorzopt), Brinzolamide (Azopt, Azarga, Brinzopt).
• Prostaglandins (Xalatan, Glaumax, Prolatan, Trilactan, Glauprost, Latanoprost, Travatan, Travapress).
• Combined drugs (Xalac, Fotil, Pilotymol, Kosopt, Dorzopt, Xalacom, Duaprost).

The drugs are selected individually, first one is prescribed, and if ineffective, drops from another group are added. It is recommended to change the regimen 2-3 times a year, as addiction develops.

For glaucoma, if treatment with drops is ineffective, surgery is prescribed - iridotomy, iridectomy, trabeculoplasty.

Prevention

• Annual examination by an ophthalmologist with IOP measurement after 40 years.
• See a doctor if your vision is impaired.
• Mandatory blood pressure monitoring in patients with chronic diseases, as well as those taking steroids.
• Adhere to the prescribed treatment regimen, do not stop the drops yourself.
• Compliance with the work and rest regime, visual regime.
• Treatment of chronic diseases.

Ocular pressure in medicine refers to the pressure that exists between the contents of the eyeball and its membrane. It is this indicator that helps determine how fully the human visual system functions.

The danger of high eye pressure lies in the complete absence of any symptoms signaling a person about the problem. When they appear and begin to bother the patient, it is already too late to correct the situation without surgical treatment. If high eye pressure persists for a long time, this indicates the development of eye disease, which can lead to complete loss of vision.

Ophthalmologists advise regularly undergoing examinations and measuring eye pressure. Any deviations from the norm indicate the development of the disease. At risk are people whose age exceeds 40 years (from 35 years if there are direct relatives suffering from glaucoma).

Eye pressure is measured in millimeters of mercury. The study during which the indicator is measured is called.

There are several measurement methods:

• non-contact method— to determine the indicator, equipment is used that affects the eye with a flow of air. This method eliminates the possibility of infection of the eye mucosa; there is no discomfort during the procedure.
• using weights- a measurement method in which a special weight with a painted area is briefly placed on the eye, then the contact patch is measured. This method is quite accurate, but there are certain risks associated with eye infection and discomfort during the procedure, which requires the use of anesthetics.

Normally, tonometric intraocular pressure should be from 12 to 25 mmHg. Art. For patients over 50 years of age, 24-hour tonometry and outflow ease coefficient (more than 0.13) are measured.

The patient is asked to drink a small amount of water (0.5 liters) in a short period of time (usually 5 minutes), then placed on the stomach with eyes closed for 30 - 40 minutes and IOP measured during the first hour. If IOP increases by 5 or more units, the sample is considered positive.

Symptoms and signs of high eye pressure

As noted earlier, the danger of the disease lies in the fact that in the early stages there may be no symptoms and may not bother the person in any way. Unpleasant sensations such as heaviness in the eyes, a feeling of “sand,” dryness, and burning are usually associated with general fatigue, lack of sleep, and working in front of a computer.

Visit an ophthalmologist urgently if you have:

• sharp visual acuity and field of vision decrease;
• appeared severe headaches which are localized in the eye or temple area;
• the eye color takes on a red tint.

All of these symptoms indicate increased eye pressure, which affects the optic nerve. If treatment is not started in time, the optic nerve may atrophy, leading to blindness.

Methods for reducing blood pressure and treating glaucoma

With a slight increase in intraocular pressure, when it is caused by eye fatigue, simple methods will help:

• gymnastics for the eyes;
• protective glasses;
• special eye drops;
• limiting eye strain (exclude TV and computer from your daily routine);
• do not engage in contact and strength sports.

If the pressure does not decrease for a long time, this indicates the development of glaucoma, which is treated at an early stage with drug therapy.

Drops that reduce eye pressure

The action of eye drops is aimed at stimulating the outflow of excess fluid accumulated in the eyes, as well as additionally supplying the eye with useful substances.

Improving the outflow of intraocular fluid:

• Latanoprost (Xalatan),
• Travoprost (Travatan),
• Timolol (Ocumed, Okumol, Okupres-E, Arutimol, Timohexal, Timolol-pos, Oftan-timolol).

Combined drugs:

• Pilocarpine + timolol (Fotil, Fotil-forte),
• Latanoprost + timolol (Xalacom),
• Dorzolamide + timolol (Cosopt),
• Proxodolol + clonidine (Proxophilin),
• Proxodolol + pilocarpine (Proxocarpine).

If the disease progresses and drug treatment does not bring the desired result, the patient is prescribed.

Prevention

1. If you work at the computer frequently and for a long time, give your eyes a break of at least five minutes every hour. At this time, you need to do eye exercises, massage your eyelids, or simply close your eyes.
2. The menu must include foods that are healthy for the eyes: blueberries, sea fish, carrots.
3. Periodically take a course of vitamin complexes for the eyes.
4. Visit an ophthalmologist once a year.

Unfortunately, if the disease is detected at a late stage and glaucoma is already developing, even modern medicine cannot stop the process. However, by being observed by an ophthalmologist and following all the instructions, you can somewhat slow down the development of the disease and live for a long time without feeling discomfort.

Everyone knows what blood pressure is, what it should be, and what its pathological changes threaten. Any person has access to a lot of information regarding the issues of hypertension and low blood pressure, methods of treating these diseases and their prevention. Fluctuations in pressure are accompanied by characteristic symptoms, by the appearance of which a person can judge whether it has decreased or increased. Not to mention the fact that the pharmacy offers many different models of measuring devices that allow you to independently control the parameter.

But unfortunately, it is impossible to say all this in relation to intraocular pressure (IOP). Few people will answer the question of what an indicator is, where it comes from and what it depends on, how its changes manifest themselves. In addition, IOP can only be measured in the ophthalmologist’s office, for which you need to visit him annually for a preventive examination, and you see, very few people do this. Let's look into these issues.

In the anterior chamber of the eyeball, intraocular fluid, or aqueous humor, which is constantly produced in the organ of vision, accumulates, the outflow of which occurs through a network of trabeculae (drainages) located right there. IOP is the pressure exerted by fluid on the sclera and cornea of ​​the eye. The value of IOP is determined by the ratio of the amount of synthesized fluid and its outflow. In addition, the indicator depends on the intensity and pressure in the veins located in the episclera.

When an excess amount of intraocular fluid accumulates, IOP increases, the eyeball begins to put pressure on the optic nerve, which leads to damage and disruption of normal functioning. The consequence of the disorder is a gradual deterioration of visual function, loss of clarity of the peripheral image, up to complete loss of vision.

An increase in IOP disrupts normal metabolism in the eye tissues, has a destructive effect on the retina, and can cause the death of the optic nerve and the development of various eye diseases. Another distinctive feature of the increasing indicator is the asymptomatic course of the initial stages of the pathology, when a person knows nothing about his condition, and the lack of treatment leads to further progression of the disease.

Why does intraocular pressure increase?

An increase in the indicator can be caused by a variety of reasons. A short-term increase in IOP (transistor type) can be caused by hypertension, stress, increased fatigue, and psychoemotional disorders. With these disorders, there is also a rise in blood pressure.

The normal intraocular pressure ranges from 11 to 21 units, and the indicator varies depending on the time of day, blood pressure level, heart rate, and respiratory rate. In a healthy person, IOP changes by no more than 5 units during the day.

By its nature, glaucoma can be primary, secondary and congenital.

Primary glaucoma can be caused by:

• Hypertension.
• Endocrine disorders - hyper- and hypofunction of the thyroid gland, diabetes mellitus. In these diseases, the synthesis of hormones that affect the level of IOP is disrupted.
• Diseases of the nervous system.
• Kidney diseases and heart pathologies, in which there is an accumulation of excess fluid in the body.
• Old age.
• Genetic predisposition.

Secondary glaucoma develops, most often, in one eye and is caused by a violation of the outflow of intraocular fluid. Its causes may be the following eye pathologies:

• Inflammatory diseases of various nature - scleritis, keratitis, uveitis.
• Lens shift.
• Cataract.
• Neoplasms of various etiologies - the tumor mechanically compresses the eye tissues.
• Traumatic eye injuries - as a result of injury, inflammation develops, which contributes to the formation of congestive processes and swelling.

Congenital glaucoma develops as a result of defects in the embryonic development of the visual organs, birth injuries and inflammatory processes.

An increase in IOP values ​​is also observed with ocular hypertension, a benign pathology that does not cause atrophic changes in the optic nerve.

How does elevated IOP manifest?

A constantly elevated level of IOP contributes to the development of glaucoma, a pathology that includes a number of diseases of various etiologies and natures. What these disorders have in common is that they all lead to destruction of the optic nerve and irreversible blindness. As already mentioned, an increase in IOP often does not cause the appearance of painful symptoms at all, and a person is not aware of problems with vision until he begins to gradually lose it.

The main symptom of the disorder is gradually increasing blindness. In addition, the patient feels:

• High eye fatigue - people often explain this unpleasant sensation by fatigue, prolonged sitting in front of a computer, etc., but it is better, without waiting for more serious manifestations, to go to an ophthalmologist and measure IOP.
• Headache - pain is felt mainly in the temporal region.
• Redness of the whites of the eyes.
• Tearfulness - with high IOP, excessive moisture of the conjunctiva is observed, while the eyes constantly water.
• Stinging in the eyes.

Intraocular pressure may increase after using certain pharmaceuticals. This disorder often develops when eye drops are used concomitantly with antidepressant drugs and corticosteroids.

How to normalize the condition?

If you suspect an increased level of IOP, you should immediately go to an ophthalmologist, who will measure the parameter,, if necessary, conduct additional examinations and prescribe a course of treatment. The method of therapy is individually selected in each individual case and directly depends on the causes of the disorder.

First of all, attention is paid to drug treatment with drugs from the following groups:

• Prostaglandins - these drugs help improve fluid circulation in the eyes, prevent the formation of stagnant processes, and normalize the outflow of aqueous humor. These drops include Xalatan and Travatan.
• β-blockers - inhibit the synthesis of intraocular fluid. These drugs include Timolol and Betoptik.
• Sympathomimetics - promote better fluid outflow due to their effect on the nerve cells located in the eye. Of the drugs in this group, adrenaline hydrochloride is most often prescribed.
• Cholinomimetics - constrict the pupil.
• Carbonic anhydrase inhibitors.

At the beginning, one drug is used for treatment, and with critically high IOP, two or more are used. Also, in case of ineffectiveness, it is possible to replace the drug. If the pathology does not respond to conservative treatment, they resort to surgical intervention - microsurgical trabeculotomy and laser iridotomy.

Lowering IOP with Exercise

Patients often ask their ophthalmologist how to relieve eye pressure at home. Special exercises and some folk remedies are great for this.

To do this, you need to regularly perform the following exercises:

• Close your eyes, hold your head still and draw various shapes with your pupils.
• Turn your head while blinking slowly, then close your eyes and continue moving. After some time, open each eye in turn.
• Concentrate your gaze on some point, for example, a picture or calendar hanging on the wall, then look sharply at another object and return your gaze to the first point.

It is important to remember to blink frequently, especially when sitting in front of a TV or computer monitor for long periods of time.

You also need to make some adjustments to your usual diet, and daily include a sufficient amount of foods rich in vitamins A and C. The menu should include seafood and sea fish, tomatoes, cabbage, carrots, fresh citrus fruits, and blueberries.

Glaucoma is a rather dangerous disease that gradually leads a person to blindness. To avoid this, it is necessary to undergo regular preventive examinations with an ophthalmologist. Modern medicine offers a wide range of medicines to choose from that can cure ailments. In addition, it is possible to treat eye pressure at home.

The main symptom of glaucoma is not immediately noticeable. The pressure inside the eye increases when the water balance in the organ of vision changes. Fluid production and functioning are disrupted. The contents of the eyeball begin to put pressure on the membranes of the eye. This leads to the fact that in the last stages of the disease, visual signals from the outside world do not reach the brain and the person stops seeing. The main causes of a dangerous symptom are:

• violation of water metabolism;
• physical and chemical eye injuries;
• use of medications - hormonal and antidepressants;
• consequences of operations on the organ of vision;
• atherosclerosis;
• hypertension;
• diseases associated with the cardiovascular system;
• other severe eye pathologies.

At first, a person may not notice increased intraocular pressure. It doesn't reveal itself at all. But there are a number of methods that can be used to determine the presence of the disease.

1. Palpation. This method is indispensable when you urgently need to measure blood pressure. The procedure can be easily performed in any conditions. You need to put your fingers to your forehead. Use your index finger to feel the moving eyelid and move it up a little. You need to touch the eyeball with your middle finger. If there is no pathology, then with very light pressure you will feel a pulsation inside the eye. In case of increased pressure, the impulse is felt only when pressing firmly on the eyelid.
2. Wireless blood pressure monitor. This special device directs air flow through the eye towards the cornea. The method is suitable for carrying out the procedure at home.
3. Tonometry of the organ of vision. Medical equipment makes an impression of the eye by applying slight pressure to the cornea. The procedure is performed in a hospital under anesthesia.

Main symptoms

Typically, treatment for high eye pressure at home is carried out when the signs of glaucoma become more severe and interfere with normal life. It is quite possible to reduce the progression of the disease if you notice the symptoms in time and begin treatment. Here are the characteristic signs of a developing disease:

• pain in the area of ​​the eyeball when lightly pressing on it;
• blurred vision;
• headaches in the forehead and temples;
• redness of the mucous membrane;
• the appearance of black spots before the eyes;
• feeling of nausea.

If these symptoms are detected, you should immediately contact an ophthalmologist.

Traditional methods

When glaucoma is detected, the doctor prescribes medications, usually special drops (for example, Oftimol) and tablets. But you can lower eye pressure at home. Traditional recipes serve as an excellent addition to mandatory treatment.

Herbal formulations

Reducing eye pressure using folk remedies is very simple. It is enough to use the recommendations below.

1. Herbal compress. You will need to take half a glass of crushed nettle leaves and add one tsp to them. lily of the valley Pour 1 tbsp into the resulting mixture. l. water. Make a compress and apply over the eyes. This composition is designed to relieve pain and lower blood pressure.
2. Aloe decoction. Cut off two leaves and soak in a glass of water. After 2 minutes, remove the greens and discard the juice, which should be poured into the main broth. This liquid should be instilled into the eyes 2 times a day.
3. Currant and rowan leaves will help relieve pressure. They need to be thrown into a liter of boiling water and brewed. The infusion can be taken instead of tea throughout the day, which also helps lower eye pressure.
4. Chickweed plant juice can relieve blood pressure symptoms. You need to squeeze a liter of juice from the leaves and add 100 grams of vodka to it. Leave for 2 days. Take a quarter glass orally 2 times a day.

Gymnastics for the eyes

A good addition to the therapeutic course are exercises for the organ of vision. The eye will relax and water balance will be restored. The treatment complex itself is quite simple.

1. Set the stopwatch timer for 1 minute and blink your eyelids very often until the final bell.
2. Do the same exercise at a slower pace.
3. Extend your hand in front of you and move your fingers, carefully following them with your eyes. Gradually zoom in on the image.
4. Mentally draw a square, triangle, figure eight, star and bow in front of your eyes.
5. Sit in front of the window and notice a bright thing next to it. Shift your gaze first into the distance on the street, then at this object. Do several repetitions.
6. Make movements with the pupils in a circle and in different directions.

Treatment of increased intraocular pressure can be carried out with folk remedies, but do not forget about control examinations with an ophthalmologist. High eye pressure is fraught with dire consequences, so if your condition worsens, you should inform your doctor.