Glaucoma
High pressure inside the eye
High pressure inside the eye is also called ocular hypertension. It can cause glaucoma, but doesn't always. That may be because some people's optic nerves can stand higher pressures than
others. Most people find out they have ocular hypertension after a routine eye check-up with their eye doctor. Your eye doctor
diagnoses ocular hypertension with a simple test called tonometry. There are no symptoms.
About 1 in 10 adults over 40 have ocular hypertension.
1 However, only about 1 in 10 people with ocular hypertension go on to get glaucoma.
2 So experts disagree about whether or not to treat the high pressure when it's not causing damage to the optic nerve.
Source:
Alward WLM.
Medical management of glaucoma.
New England Journal of Medicine. 1998; 339: 1298-1307.
Alward WLM.
Medical management of glaucoma.
New England Journal of Medicine. 1998; 339: 1298-1307.
Source:
Kass MA, Heuer DK, Higginbotham EJ, et al.
The Ocular Hypertension Treatment Study.
Archives of Ophthalmology. 2002; 120: 701-713.
Kass MA, Heuer DK, Higginbotham EJ, et al.
The Ocular Hypertension Treatment Study.
Archives of Ophthalmology. 2002; 120: 701-713.
A lot of research has been done on whether to treat this high pressure, but the results are very mixed. We haven't yet judged
these studies using the same scientific standards that we use to judge other studies on this site. But we are including details
because you may have questions about these treatments.
A summary of five high-quality studies (called
randomized controlled trials) suggests that if you have ocular hypertension, using prescription eye drops can cut your risk of glaucoma by about half, over five years.
3 These eye drops contain medicine to bring down the pressure in your eye.
randomised controlled trials
Randomized controlled trials are medical studies designed to test whether a treatment works. Patients are split into groups. One group is given the treatment being tested (for example, an antidepressant drug) while another group (called the comparison or control group) is given an alternative treatment. This could be a different type of drug or a dummy treatment (a placebo). Researchers then compare the effects of the different treatments.
Randomized controlled trials are medical studies designed to test whether a treatment works. Patients are split into groups. One group is given the treatment being tested (for example, an antidepressant drug) while another group (called the comparison or control group) is given an alternative treatment. This could be a different type of drug or a dummy treatment (a placebo). Researchers then compare the effects of the different treatments.
Source:
Maier PC, Funk J, Schwarzer G, et al.
Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials.
BMJ. 2005; 331: 134.
Maier PC, Funk J, Schwarzer G, et al.
Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials.
BMJ. 2005; 331: 134.
But another study found that treating ocular hypertension with eye drops did not help stop glaucoma.
4 Between 1 in 10 and 2 in 10 of the people in this study went on to get glaucoma, whether they used eye drops or a pretend
treatment (called a
placebo). The study lasted five years.
Source:
The European Glaucoma Prevention Study Group.
Results of the European glaucoma prevention study.
Ophthalmology. 2005; 112: 366-375.
The European Glaucoma Prevention Study Group.
Results of the European glaucoma prevention study.
Ophthalmology. 2005; 112: 366-375.
placebo
A placebo is a 'pretend' or dummy treatment that contains no active substances. A placebo is often given to half the people taking part in medical research trials, for comparison with the 'real' treatment. It is made to look and taste identical to the drug treatment being tested, so that people in the studies do not know if they are getting the placebo or the 'real' treatment. Researchers often talk about the 'placebo effect'. This is where patients feel better after having a placebo treatment because they expect to feel better. Tests may indicate that they actually are better. In the same way, people can also get side effects after having a placebo treatment. Drug treatments can also have a 'placebo effect'. This is why, to get a true picture of how well a drug works, it is important to compare it against a placebo treatment.
A placebo is a 'pretend' or dummy treatment that contains no active substances. A placebo is often given to half the people taking part in medical research trials, for comparison with the 'real' treatment. It is made to look and taste identical to the drug treatment being tested, so that people in the studies do not know if they are getting the placebo or the 'real' treatment. Researchers often talk about the 'placebo effect'. This is where patients feel better after having a placebo treatment because they expect to feel better. Tests may indicate that they actually are better. In the same way, people can also get side effects after having a placebo treatment. Drug treatments can also have a 'placebo effect'. This is why, to get a true picture of how well a drug works, it is important to compare it against a placebo treatment.
If you have ocular hypertension, you should discuss the pros and cons of treatment with a doctor who specializes in conditions
affecting the eye (an ophthalmologist). Your decision will probably depend on your personal circumstances, including:
- How high the pressure is, and whether it's affecting one or both of your eyes
- Your background risk of glaucoma, including your age, your family history, and your ethnic background
- How you feel about using eye drops every day for many years
- How you feel about the possibility of side effects from treatment.
Sources for the information on this page:
- Alward WLM.Medical management of glaucoma.New England Journal of Medicine. 1998; 339: 1298-1307.
- Kass MA, Heuer DK, Higginbotham EJ, et al.The Ocular Hypertension Treatment Study.Archives of Ophthalmology. 2002; 120: 701-713.
- Maier PC, Funk J, Schwarzer G, et al.Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials.BMJ. 2005; 331: 134.
- The European Glaucoma Prevention Study Group.Results of the European glaucoma prevention study.Ophthalmology. 2005; 112: 366-375.
This information was last updated on Jul 29, 2008
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
© BMJ Publishing Group Limited 2009. All rights reserved.
The information on ConsumerReportsHealth.org should not be viewed as a substitute for a consultation with a medical or health professional.
The information is meant to enhance communication with your doctor, not replace it. Consumers Union can not be liable for any loss, injury, or other damages related to your use of this information.
Your use of this information is subject to our User Agreement available at www.ConsumerReportsHealth.org.
Your use of this information is subject to our User Agreement available at www.ConsumerReportsHealth.org.
Source: ConsumerReportsHealth.org Copyright © 2005-2008 Consumers Union of U.S., Inc.
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