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Question from California At what point (if ever) should someone who has ocular hypertension be treated for glaucoma? I am 40 and for about 10 years I have routinely had readings in the 26 range, and they have been as high as 32, but have no other symptoms of glaucoma.Ocular hypertension usually means elevated pressure in the eye without known damage to the optic nerve. When detailed visual field testing does not show any peripheral vision abnormalities and when the optic nerve appears to be normal, there may be no treatment necessary for ocular hypertension. However, it always needs to be watched very closely, often at three to four month intervals to determine whether any damage is occurring. In some cases, despite the absence of damage, medication will be used as a preventative to avoid the chance that optic nerve damage or visual field damage could occur in the future. The main reason to consider preventative treatment is that any damage that does occur can usually not be reversed, so it requires very close monitoring to ensure that the ocular hypertension has not transformed itself into true glaucoma with some detrimental effects on vision. Question from Turkey Glaucoma describes the disease in which high pressure in the eye causes damage to the optic nerve and eventual loss of vision. High intraocular pressure can occur without causing damage to the nerve, and thus high pressure does not automatically mean that someone has glaucoma. However, everyone with higher than normal intraocular pressure is at risk for glaucoma and should be evaluated repeatedly over the time during which their pressure remains elevated. A pressure of 20-24 mm Hg is modestly elevated, and many people with pressures in this range do not necessarily lose any vision. However, it is possible to have optic nerve damage and vision loss even if pressure is below 20, so the level you described should always be checked on a routine basis. |
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