Ocular Hypertension: What You Need to Know
Ocular hypertension means your eye pressure is higher than normal but the optic nerve shows no damage yet. High pressure raises your risk of glaucoma, so doctors usually take it seriously even if your vision looks fine. This page explains how it’s found, who’s at risk, and what choices you have to protect your sight.
How it’s diagnosed: Pressure is measured with tonometry. Doctors may also use pachymetry to check corneal thickness, optical coherence tomography (OCT) to look at the optic nerve, and visual field tests to spot early changes. A single high reading doesn’t prove ocular hypertension—doctors want repeated measurements and a full check before deciding on treatment.
Risk factors include older age, a family history of glaucoma, African or Latino ancestry, thin corneas, extreme near- or far-sightedness, diabetes, and long-term steroid use. If you use steroid drops or inhalers, tell your eye doctor—steroids can raise eye pressure for some people.
Treatment options
Many people with ocular hypertension are watched closely without immediate treatment. If your risk is low, regular checkups every six to twelve months might be enough. If the risk is higher, or tests suggest the optic nerve could be vulnerable, treatment usually starts with eye drops. Common classes are prostaglandin analogs, beta-blockers, carbonic anhydrase inhibitors, and alpha agonists like brimonidine (Alphagan). Each has pros and side effects—prostaglandins often lower pressure well and work once a day; beta-blockers can affect heart or lungs and need a doctor’s review.
Laser trabeculoplasty is a non-surgical option to lower pressure when drops are insufficient or unwanted. It can reduce the need for daily medication. Surgery is rare for ocular hypertension but may be considered if pressure stays high despite other steps.
Practical tips to protect your eyes
Keep follow-up appointments and take prescribed drops exactly as directed. Missing doses reduces protection. Avoid over-the-counter steroid eye drops unless prescribed. Share your full medical history and medication list with your eye doctor, including inhaled steroids or skin creams. Lifestyle habits like regular exercise, a healthy diet, and not smoking help overall eye health, though they won’t replace medical treatment for high pressure.
Questions to ask your eye doctor: What is my eye pressure and how many measurements support that number? What is my estimated risk of converting to glaucoma? Which medication do you recommend first and why? What side effects should I watch for and how will we test if the drops are working? Ask how often you need OCT and visual field testing. If you use other medications or have heart or lung disease, mention that—some eye drops interact with other conditions. If you travel a lot or have trouble with daily drops, ask about laser as an alternative.
If you notice vision changes, flashes, sudden pain, or a colored halo around lights, get urgent care. Those symptoms may signal acute issues needing same-day treatment. For most people with ocular hypertension, careful monitoring and the right mix of treatment keep sight safe for years.
