High eye pressure: what it means and what you can do
High eye pressure (intraocular pressure or IOP) means the fluid inside your eye is higher than normal. That extra pressure can damage the optic nerve and lead to glaucoma over time. Not everyone with high IOP develops glaucoma, but you should take it seriously—early action prevents vision loss.
How doctors measure and diagnose
Eye pressure is measured with tonometry. A normal range is usually about 10–21 mmHg; readings above 21 mmHg are considered high. Your eye doctor won’t decide based on one number alone. They check the optic nerve, test your visual field, and may take eye images (OCT). If the optic nerve looks healthy and vision is fine, your doctor might call it "ocular hypertension" and recommend monitoring or treatment depending on your risk.
Risk factors that push a doctor toward treatment include a family history of glaucoma, thin corneas, age over 60, high myopia (nearsightedness), and certain medical conditions like diabetes. Using steroid medications—especially steroid eye drops—can raise eye pressure, so mention any steroid use to your doctor.
Treatment options and practical tips
First-line treatment is almost always eye drops. Common classes and examples include:
- Prostaglandin analogs (latanoprost, bimatoprost): once-daily drops that lower IOP by improving fluid outflow.
- Beta blockers (timolol): reduce fluid production, usually twice daily.
- Alpha agonists (brimonidine): both reduce production and increase outflow.
- Carbonic anhydrase inhibitors (dorzolamide, brinzolamide): lower fluid production.
- Rho-kinase inhibitors and combination drops are also options in some cases.
Follow the drop schedule exactly. Missed doses reduce effectiveness. If side effects bother you (red eyes, stinging, slow heart rate concerns with beta blockers), tell your doctor—there are alternatives.
If drops aren’t enough, your doctor may suggest laser treatment (selective laser trabeculoplasty) to improve drainage, or surgery to create a new drainage pathway. These options reduce reliance on daily drops for many people.
Simple daily habits help too: keep regular eye exams, don’t skip follow-ups, and avoid long-term steroid use unless monitored. Moderate aerobic exercise can lower IOP slightly; heavy weightlifting or straining can raise it temporarily, so use caution. Limit excessive caffeine if you notice spikes after coffee. Sleep with your head slightly elevated if your doctor recommends it—lying flat can raise eye pressure during the night.
Know the red flags: sudden severe eye pain, nausea, sudden vision loss, or seeing halos around lights. Those symptoms can mean acute angle-closure glaucoma—a medical emergency. If that happens, go to the ER or eye clinic immediately.
High eye pressure is manageable for most people. Ask questions, get baseline tests, follow treatment plans, and report any new symptoms fast. That approach keeps your risk low and your vision safer for years to come.
