High intraocular pressure

Introduction High intraocular pressure refers to repeated measurements of intraocular pressure above the normal range, but after long-term follow-up, does not cause changes in the optic papilla and visual field. High intraocular pressure is associated with increased secretion of aqueous humor and may also be associated with endocrine disorders.

Cause

1. Female patients, elevated blood pressure and winter are associated with high intraocular pressure. There are many women with ocular hypertension, and most of them are over 40 years old, suggesting that there may be a certain relationship with endocrine changes in women, especially autonomic dysfunction in premenopausal period.

2. The accompanying phenomenon of elevated blood pressure and elevated intraocular pressure is also associated with autonomic dysfunction of autonomic nerve function of blood vessels.

3, the relationship between intraocular pressure and seasonal changes and daytime changes (often higher in the morning) is believed to be related to the cyclical changes of corticosteroids in the body.

4, in addition to high intraocular pressure related systemic factors are race (black is more common), height, weight and pulse rate, diabetes and smoking.

5. The factors related to local eye and high intraocular pressure are mainly dark iris (ie, iris pigmentation), corneal thickness and myopia. As for the age factor, the intraocular pressure in the Westerners has increased with age, but epidemiological data from Japan and China show that the intraocular pressure decreases with age.

an examination

Related inspection

Intraocular pressure ophthalmoscopy, near vision test, ophthalmologic examination, eye function examination

Clinical manifestations and examinations:

Because the clinical situation of ocular hypertension is more complicated, and indeed some ocular hypertension will eventually develop into primary open angle glaucoma, therefore, in addition to regular follow-up observation of ocular hypertension (regular review of intraocular pressure, optic disc) , retinal nerve fiber layer and visual field), for some ocular hypertension with primary open angle glaucoma risk factors or visual field damage risk factors, most scholars tend to adopt "protective" intraocular pressure reduction treatment, including Ocular hypertension with the following risk factors:

1. Intraocular pressure 4kPa (30mmHg).

2. There is a family history of positive glaucoma.

3. The contralateral eye is a primary open angle glaucoma.

4. High myopia.

5. The disc is large.

6. Accompanied by systemic hemodynamics and hemorheological abnormalities that can cause optic disc hypoperfusion, such as diabetes, hypertensive cerebral vascular stroke, peripheral vasospasm, hyperviscosity and the like.

The "protective" ocular hypotensive treatment is treated with drugs, and the principle of selecting drugs is the same as that of primary open angle glaucoma.

For mild ocular hypertension such as intraocular pressure <4 kPa (30 mmHg), there is no risk factor associated with visual field damage, and tend to be followed up regularly, and no treatment is given.

Differential diagnosis

Differential diagnosis:

Patients with ocular hypertension should be identified with early POAG patients who have not had optic disc damage and visual field defects.

1. Using any drug, repeatedly measure intraocular pressure > 21 mmHg (2.79 kPa).

2, fundus examination is normal.

3. The visual field examination is normal.

4. The corner is open.

5. The intraocular pressure tracing value is normal.

6. There was no damage to the optic nerve fiber layer in the fundus photography.

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