Boğaziçi Tıp Dergisi (Sep 2019)
How to Approach the Patients with High Intraocular Pressure?
Abstract
INTRODUCTION[|]The aim of this study is to indicate that it is not enough to only measure the intraocular pressure in order to be able to diagnose glaucoma in patients with high intraocular pressure. In order to initiate medical treatment for the patients, it is necessary to support the recognition by some objective tests (visual field test, optical coherence tomography, Heidelberg retina tomography) besides the intraocular pressure elevation.[¤]METHODS[|]A total of 725 patients and 1450 eyes were included in the study. The patients were between 35 and 83 years of age. Biomicroscopic anterior and posterior examination findings, intraocular pressure, and cup/disc ratio data were recorded. Intraocular pressure measurements were performed with a pneumatic tonometer (HN-7000; Huvitz, Anyang-si, Republic of Korea). Patients with an intraocular pressure >21 mmHg were followed up for. Medical treatment was initiated for patients who had pseudoexfoliation with an intraocular pressure >21 mmHg. Other patients with a high intraocular pressure were further evaluated by the glaucoma unit with pachymetry, visual field testing, optical coherence tomography, and Heidelberg retinal tomography tests.[¤]RESULTS[|]The intraocular pressure was >21 mmHg in 2 measurements taken at a 1 week interval in 16 of the 725 patients (2.2%). These patients were referred to the glaucoma unit for a detailed glaucoma examination. In 13 patients, while the first intraocular pressure measurement was >21 mmHg, the second measurement was normal and these patients were followed up periodically. Antiglaucomatous treatment was initiated for 3 patients who had pseudoexfoliation and an intraocular pressure >21 mmHg.[¤]DISCUSSION AND CONCLUSION[|]Measurement of intraocular pressure is an indispensable part of the eye examination. However, high intraocular pressure is not sufficient medical treatment for glaucoma. The diagnosis should be confirmed using other objective tests, such as optical disc imaging, retinal nerve fiber analysis, and a visual field test to avoid unnecessary medical treatment.[¤]
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