Eye pressures

[Fran555]

I went for my yearly eye check this week, which I always dread, and the pressure in both my eyes is 23. (Last year the pressure in my left eye was 24, so I guess this is one good thing). I don't have glaucoma (yet). I have read that some professionals now put the normal eye pressure range from 12 to 24, though most still stick to 11-21/22. I don't feel happy about my pressures even though the optician said I have nothing to worry about. I am 64, short sighted, and my late father had glaucoma, so I know the risk I will get it is real. I was on edge and very nervous during the exam, which could have had an effect. I guess I just want some reassurance that-for the present-I have nothing to worry about.

[rhys1234]

Erm...........how do you know, exactly , that you 'don't have glaucoma' ?

And who was it told you your pressures were nothing to worry about ?

Personally, if it were me, with your family history, and your age, I would be ( fairly urgently ) asking the GP if I could be referred to the nearest glaucoma Consultant with a view to a full hospital checkout using their sophisticated machines, and with a full on Consultant's expertise.

With all due respect to opticians I would prefer to get my reassurance from someone with the training and experience of a Consultant.

[Fran555 in reply to rhys1234]

I am seeing my GP next Wednesday and will ask him to refer me to the hospital. But what if he says just to trust the optician? The optician said I don't have glaucoma after checking for it.

[Sufitzy]

Hi I also have a situation where the pressure where around 24 and the consultant said I did not have glaucoma and I was also concerned. A follow up with a different consultant resulted in my being put on drops . He diagnosed High ocular pressure/ glaucoma and explained that though he couldn’t see any damage had occurred (which is one diagnostics) he would used the drops to treat the high pressure and reduce likelihood of damage occurring. Made so much more sense and was reassuring . I suggested get a second opinion and query treating the high pressure .

Sx

[Fran555 in reply to Sufitzy]

I will see if my GP will refer me to a consultant. Am not at all happy about 23 pressure in both eyes.

[Sufitzy in reply to Fran555]

It’s going to be ok. You are being proactive that’s the important fact . Keep us updated xx

[rhys1234]

If the GP shows any resistance whatever ( which by the way I doubt s/he will do ) to referring you to a glaucoma Consultant, then at that point INSIST that s/he does so.

Even if it should ultimately prove to be the case that you do not have glaucoma and in addition that there is no need to put you on the drops to reduce pressure to stave it off, even so, you need the peace of mind which reassurance on those points will provide : and such can ONLY be provided by a fully qualified and experienced Consultant in the specialism.

Have you, btw, looked at the website of your nearest hospital with opthalmology Consultants ? The website may even list their names, qualifications and experience. You might then wish to contact their secretaries and ask for the best way to get a referral.

[Bluella]

Hi Fran555, I have a similar situation - my eye pressures have been increasing steadily for the past 7 years, from around 17 when it was first flagged up to me at a routine eye test (I even did not have a clue that you could have a high intraocular pressure!) to 24 and 29 at the last visit. The optician asked me to come back to re-test the following week and the results were 22 and 24. How did she manage to get such a drop in readings within one week I wonder but as both were below 24, she said GP would not refer me to see an ophthalmologist. There was no optic nerve damage, therefore no glaucoma. She did notice change to macula though but told me to monitor at home to see if reading lines are straight. But I am also thinking should I be seen by a specialist doctor, should I be getting some preventaive treatment ie drops or do I wait until damage occurs and I am then diagnosed with glaucoma. It seems to me like a lack of preventative care to say the least. I'm 59 btw, and no family history with glaucoma. I hope your GP is sympathetic and refers you.

[Fran555 in reply to Bluella]

Like you I wonder if I will be left to wait till damage occurs, till some (or even a lot of) sight is lost, and I am then diagnosed with glaucoma. It is not reassuring at all and, to be honest, it feels very much that this is what is happening. Preventative care should be offered. Did your optician use a different test the second time when she got lower readings? This could explain the drop in pressure if she did.

[Bluella in reply to Fran555]

The first time, the optician used the air puff test, followed by the touch one, and the following week just the touch one. Let us know how you got on with your GP visit. Best wishes

[Fran555 in reply to Bluella]

I phoned the optician's and asked for a referral and she agreed to this, though she did say that 23 is normal eye pressure. She is writing to the hospital to get me an appointment. She said I might not be seen by a consultant, but I guess that all the doctors in opthalmology will be trained to detect glaucoma

[Bluella in reply to Fran555]

That's great news, I did not know opticians could make direct referrals to hospitals, I thought they were making recommendations to your GP to do so. So that's good news.

[Engima]

As others are saying you would be well advised to be checked by a consultant. I went for years with high pressure and kept being told I didn't have glaucoma - although to be honest my optician did refer me. It was the consultant who said I only had extra thick corneas, but after having to miss my 2020 appointment due to the Covid pandemic, when I went in June this year, lo and behold a different doctor at the eye clinic said I had glaucoma. So am now on eye drops and three monthly check-ups. I do hope though that you haven't got glaucoma, but it is better to be safe than sorry. Wishing you all the best. x

[Trish_GlaucomaUK Partner]

Most Opticians take a photo of the back of the eye at appointments nowadays. If this was the case, and they could see that your optic nerve was ok, this could be the reason why they felt a referral wasn’t needed.

The NICE guidelines say that if a person has an IOP of 24mmHg and above they should be referred to see an eye specialist. As your father has glaucoma and you have another eye condition, you could go back and ask the optician to refer you. This needs to be done before the GP can do anything.

Alternatively, if you are in the position to do so, you could see a consultant privately without a referral.

[Fran555 in reply to Trish_GlaucomaUK]

I have called Specsavers and am waiting for an optician to phone me back about a possible referral. If they refuse, I will go to a different optician for a second opinion

[Fran555 in reply to Trish_GlaucomaUK]

The optician did take a photo of my eyes and said they were fine. Anyway, she has agreed to refer me to the hospital. I hope from now on that, if I don't have glaucoma, that my annual check ups will be at the hospital as it would make me feel a bit more secure.

[Hidden]

Some good answers here. I'd add a couple of points.

It is possible to have ocular hypertension (high eye pressures) without glaucoma. Not everybody with elevated eye pressures go on to develop glaucoma, but it is a known risk factor.

Also, do you know whether you have thick corneas? Thick corneas can cause the pressure measurement to appear higher than it actually is, and vice versa. I've seen conflicting information as to whether the true pressure can actually be determined.

[Fran555 in reply to Hidden]

I don't know if I have thick corneas; would the optician know from the eye tests?

[Hidden in reply to Fran555]

It's a different machine from the slit lamp that you rest your chin on. When I've had my corneas measured it's been a little handheld tool with a point that they hold momentarily on the middle of your cornea (under topical anaesthetic). I think it might be specialist equipment that a regular optician may not have.

[Fran555 in reply to Hidden]

I don't remember ever having this test done, though I have vague memories of a machine which may have touched my eyes years ago. My optician has called me back and is writing to opthalmology at the local hospital to get me an appointment. She said it might not be with a consultant. I'm not sure who else they may have working there other than consultants, but as long as they check my eyes out thoroughly, this is what matters.

[Ilovecake-]

I didn’t think there was a one pressure number fits all , I was led to believe it was an individual thing . When I first started out my pressures were from 18 to 20 and my consultant said he wanted. them down to between 12 and 10 and anywhere below 10 for me was good.

Since I had a presser shunt fitted I am now at 8and he said that’s perfect . So we are all different.

[Fran555 in reply to Ilovecake-]

I thought this as well. Ten years ago I got readings in the early 20s, though they came down a bit when I relaxed when he did a second test. So my eyes have had high pressure at least part of the time for at least a decade.