What is ocular hypertension?

Ocular hypertension is a medical term for excessive fluid pressure inside the eye. It's also known as glaucoma, high eye pressure, or high intraocular pressure. Between 3 million and 6 million people in the United States have this condition.

Without treatment, ocular hypertension can turn into glaucoma, a disease that damages the optic nerve. In severe cases, it can cause blindness. Although high eye pressure sounds scary, various treatments can reduce your risk of glaucoma and vision loss. Think of these treatments as Superman rescuing Lois Lane from yet another crisis. 

The type of treatment you need depends on how quickly you discover your ocular hypertension. If you have few risk factors for glaucoma, your eye care professional might recommend getting regular exams.

Some people are more likely than others to develop glaucoma. If you drew the short end of the stick, your eye care professional might recommend medication to lower your eye pressure. You may even qualify for a procedure called selective laser trabeculoplasty. It's a mouthful, but it just involves a laser and a little fluid drainage to help prevent glaucoma.

Before diving into the potential treatment options, it's helpful to understand the potential causes and common symptoms. High eye pressure typically develops due to the overproduction of eye fluid or a problem with the eye's drainage system. You can even develop high intraocular pressure due to stress, so consider lighting your aromatherapy candle or sipping some chamomile tea while reading about this condition.

How serious is ocular hypertension?

Ocular hypertension can have some serious consequences, but it's treatable. Instead of panicking, schedule an in-person visit with an eye care professional who can assess your eyes and develop an effective treatment plan.

Remember, untreated ocular hypertension can lead to glaucoma or even blindness. It's best to channel your inner hero, put on a brave face, and get yourself to an eye care professional.

Causes of ocular hypertension

High intraocular pressure has a genetic component, but it can occur even if the rest of your family has been blessed with good vision. There are two main causes of ocular hypertension:

• Your eye makes too much aqueous humor — a clear, watery fluid, not a silly pun.

• You have some type of problem with your eye's drainage system.

This drainage system is known as the anterior chamber angle. Don't panic! You don't need to remember geometry class to understand this condition. Your eye is always producing fluid, but that fluid needs somewhere to go. The anterior chamber angle allows the aqueous humor to drain. Once this fluid leaves your eye, it enters your bloodstream.

In some cases, the drainage angle doesn't work the way it should. This can happen for a few reasons:

• The drainage angle is closed.

• Eye cancer is blocking the drainage angle.

• The drainage angle is blocked by protein flakes or pigment.

• You have previous eye damage.

• The chamber is open but isn't draining properly.

Symptoms: What does ocular hypertension feel like?

Ocular hypertension doesn't feel the same for everyone. Some people experience a sense of heaviness in their eyes, while others have blurry vision or sensitivity to light. 

Additional high eye pressure symptoms include:

• Mild discomfort: When you're sensitive to light, bright lights can hurt your eyes and make it harder to see. If you've ever squinted while walking out of a cave-like office building into direct sunlight, you know what we mean.

• Headaches: High eye pressure can cause headaches, making it difficult to concentrate. Pain behind the eyes rather than at the top or back of your head is common. If you have pain elsewhere, you may have another type of headache.

• Halos around lights: Halos are bright circles around a light source, such as a table lamp or an overhead light. (But they're usually not a holy message from above, just an indication of high eye pressure.) If your halo vision makes it difficult to drive at night, don't be afraid to use a rideshare service or ask a friend to chauffeur you around town.

• Nausea and vomiting. In severe cases, high intraocular pressure can cause nausea and vomiting. If you experience these symptoms, schedule an appointment with a health care provider.

Treatment

There's no cure for ocular hypertension, but it's definitely treatable. Some eye care professionals recommend watchful waiting. This involves getting regular eye exams to make sure the pressure in your eye doesn't increase. 

You may need medication to keep your eye pressure in check. These are some of the most common drug classes used for this purpose:

• Beta blockers: Beta blockers reduce eye pressure by slowing down the production of aqueous humor. The less fluid you have, the less that needs to drain from the anterior chamber. In this case, less is truly more.

• Prostaglandin analogs: Prostaglandin analogs are for people who have primary open-angle glaucoma. These medications reduce the flow of aqueous humor by about 30%.

• Alpha agonists: Scientists don't know exactly how alpha agonists work to reduce eye pressure. However, they know these medications pull double duty by slowing fluid production and increasing outflow.

• Carbonic anhydrase inhibitors: Carbonic anhydrase inhibitors also reduce fluid production. This prevents too much fluid from building up in the eye.

• Combination medications: Some eye care professionals recommend more than one medication to control eye pressure. Taking two drugs creates a one-two punch that may be more effective than taking a single drug.

• New eye drops: Ocular hypertension has serious effects, so drug companies have been developing new treatment options. Netarsudil increases fluid drainage, which reduces pressure in the eye. Netarsudil-latanoprost also reduces pressure, but it's even more effective because it has two active ingredients.

Prevention

Because ocular hypertension has a genetic component, you can't always prevent it. However, it's still good to know what causes high eye pressure and how to reduce it. Even if you can't stop high eye pressure completely, you may be able to prevent it from getting worse.

Follow these health tips to reduce your risk:

• Wear sunglasses on bright days.

• Wear goggles or other protective gear when playing contact sports.

• Take frequent breaks when working with digital devices.

• Clean your contact lenses properly to avoid infections. 

• Eat your vegetables (seriously). 

• Eat fish high in omega-3 fatty acids.

• Meditate, get massages, or take other steps to reduce stress.

Knowing how to reduce eye pressure can help you reduce the risk of developing ocular hypertension during your lifetime.

Take care of your eyes

Ocular hypertension is fairly common. Fortunately, you can take steps to reduce your risk or prevent it from progressing. Once you have an in-person visit with an eye care professional, schedule regular follow-up appointments. In the meantime, visit our website to find your preferred brand of contacts.

Original publish date: 1/27/2023

Updated date: 12/22/2025