When you ever went for an eye exam, did the doctor blow something into your eye like a stream of air? Or did they put a little needle in your eye and look at it? Many people think that this is just a test to see what your eyesight is. But what is actually being measured is the pressure inside your eye. Today, let's talk about what this eye pressure is, or what is medically called Intraocular Pressure (IOP) .
What exactly is intraocular pressure?
Simply put, this refers to the pressure of the fluid inside your eye. Think of our eye as a small ball filled with water. In order for that ball to maintain its shape, there needs to be some pressure inside. That's how important this pressure is to the health of our eyes and our vision.
There are two main types of fluids inside our eyes.
- Aqueous Humor: This is a watery fluid found in the front part of the eye (between the sclera and the lens).
- Vitreous Humor: This is a thick, gel-like substance located in the large chamber at the back of the eye.
Our body regulates the pressure in our eyes in a very amazing way. As new aqueous humor is produced inside the eye, an equal amount of old fluid is drained out of the eye. This fluid is drained out through a very fine drainage system in the eye. We call this the drainage angle. This process is like turning on a tap and turning on the drain in a sink. The water comes in and goes out, so the sink neither fills nor empties. But when this balance is lost, problems begin.
When the pressure in the eye rises above the normal level, we call it Ocular Hypertension . If this is not treated, it can damage the delicate parts inside the eye, especially the optic nerve that carries our vision to the brain. This damage to the optic nerve can lead to a condition called Glaucoma , which can lead to permanent vision loss if left untreated.
Why does eye pressure increase?
Although our bodies usually regulate this pressure, sometimes this balance can be disrupted. Here are the main reasons why.
| Cause | Simply put... |
|---|---|
| Excessive production of aqueous humor | Too much fluid builds up inside the eye. Then, more fluid accumulates inside than drains out. |
| Blockage of the drainage angle | The drainage canal for the fluid that builds up becomes blocked, which increases the pressure inside the eye. |
| Eye Trauma/Injuries | When something hits or injures the eye, this delicate system inside can become disrupted. |
| Some medications | This condition can be caused by medications, especially corticosteroids (eye drops, pills, ointments). Therefore, do not use these without the advice of a doctor. |
How is eye pressure measured?
This pressure measurement is called tonometry . Your eye care specialist will do this during an eye exam. It is measured in millimeters of mercury (mmHg). This is the same unit that your blood pressure is measured in.
The normal pressure in a healthy eye is between 10 mmHg and 20 mmHg .
This test is often done in two ways:
1. Air Puff Tonometry: This involves a machine blowing a small air stream into your eye. The pressure is measured by measuring how much the clear front part of the eye (cornea) pushes into the air stream.
2. Contact Tonometry: In this method, the doctor puts numbing drops in your eye and then gently touches a very small instrument to the surface of your eye to measure the pressure.
How does it feel when eye pressure increases?
This is the most dangerous thing about this disease and the thing we need to pay attention to.
Most of the time, high eye pressure doesn't cause any symptoms. The only way to know if you have it is through an eye exam. Symptoms usually start to appear after the optic nerve is damaged and your vision is affected. By then, some of the damage has already been done.
That's why it's so important to have regular eye exams, especially after the age of 40, even if there's no discomfort.
When should you see a doctor?
Although increased eye pressure usually does not cause symptoms, certain symptoms may appear in some emergency situations or as glaucoma progresses.
| When to seek medical advice | |
|---|---|
| If you have these symptoms, see a doctor immediately: | |
| |
| Go to the Emergency Department (ETU) immediately if these things happen: | |
|
Is blood pressure one thing, eye pressure one thing, or two things?
Yes. This is a point where many people get confused. High blood pressure (Hypertension) and high eye pressure (Ocular Hypertension) are two different conditions. Just because you have high blood pressure doesn't necessarily mean your eye pressure is high. One doesn't directly cause the other.
But, remember this: People with high blood pressure are at higher risk of developing glaucoma. Also, if blood pressure gets too high or too low, the blood supply to the optic nerve can be affected, causing vision loss. So, if you have high blood pressure, it's important to talk to your doctor, be aware of your risk of glaucoma, and get regular eye exams.
Your doctor may prescribe eye drops, laser treatment, or even surgery as treatment. This will be determined by examining a number of factors, including your eye pressure and the condition of your optic nerve.
Take-Home Message
- Intraocular pressure (IOP) is essential for the health of our eyes, but it should always remain at a certain level (10-20 mmHg).
- Since increased eye pressure (ocular hypertension) often does not show any symptoms, it is very important to have regular eye exams.
- If this condition is not controlled, it can lead to glaucoma, which can lead to permanent vision loss.
- If you are over 40 years old, have a family history of glaucoma, or have conditions such as diabetes or high blood pressure, be sure to have your eyes checked at least once a year.
- Follow your doctor's instructions exactly. It is especially important to use eye drops at the right time and in the right dosage.
👩🏽⚕️ Additional questions (FAQs)
💬 Procainamide injection/tablets is a very powerful medicine given for which disease?
This is no ordinary medicine! This is an extremely powerful medicine used in hospitals to save lives in severe 'Antiarrhythmic - Class 1A' conditions, especially when the lower chambers of the heart suddenly beat uncontrollably and the patient is about to die (Life-threatening Ventricular Arrhythmias / V-Tach)!
💬 When the heart is beating like crazy, how do you normalize the heart rhythm by giving this medicine (Procainamide)?
The heart beats fast due to electricity (Action Potentials)! For the first beat, 'Sodium' particles need to come in to charge the cells. When this pill enters the heart, it blocks and locks all the gates that allow sodium in. In addition, it forcibly prolongs the time it takes for the cells to charge and reset (by blocking potassium through the NAPA metabolite)! This prevents the heart from beating quickly and slows down the rhythm.
💬 What are the 'fatal dangers (Black Box Warning / Lupus)' that people taking this medicine (Procainamide) should know about?
The biggest danger is that it can cause 'a completely new and fatal heart rhythm (Proarrhythmia)' (that's why it is only given in an emergency)! The other biggest and most disturbing danger is that after using this for a few months, more than 30% of patients will definitely develop a serious disease called 'Lupus-like Syndrome' (butterfly-shaped redness of the face, joint pain)! There is also a great risk of death due to the complete destruction of white blood cells (Agranulocytosis).
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