Elevated eye pressure in teen?

Question

My son had a routine eye exam and his eye pressure was at 18 and 22. His vision is 20/20. The doctor asked that he be re-checked in two weeks. His pressure on Saturday when he was re-checked was 23 and 27. The doctor has referred him to an MD and wants to do a HRT/GDX scan. His optic nerves look perfect and his peripheral vision is completely okay as well

What does this mean? As his vision is 100% okay, could it be a fluke reading? Or does this mean he has glaucoma and will need to be on medication for the rest of his life? Does corneal thickness have anything to do with the high intra ocular pressure and if his corneal thickness is high, does that mean this pressure is normal for him? My husband was diagnosed as a glaucoma suspect last year with readings of 33 and 37 and has been on eye meds since then and has normal pressure now.

Answer 1

Glaucoma is a disease of the optic nerve.  Basically the optic nerve is killed off.  One factor that is related in a lot of cases is high IOP (intraocular pressure).  (But high pressure doesn't necessarily mean glaucoma, and glaucoma doesn't necessarily mean high pressures.)  If his optic nerves look perfect, he does not have glaucoma.

Some people just have high pressures and never develop any problems.  It's just normal for them.  His doctor just wants to monitor him right now to see if these pressures are normal for him.  Glaucoma is about noticing changes in the eyes, so it is good that the doctor wants to start watching him.

Corneal thickness can affect pressure readings.  Pressures are measured by the pressure that the eyeball presses back on a small cone-shaped insturment (Goldmann applanation tonometry).  If the cornea (which is the front of the eye) is thick, the pressure reading may be higher than it should be.  The doctor should be able to use the corneal thickness measurement to better understand the pressure measurement.

The HRT/GDX scan will give more information about the optic nerve and the layers around it.  This is very helpful because (as I said earlier), it is really the optic nerve that one has to be concerned about with glaucoma.

The ophthalmologist should be able to explain more about his specific risks once he or she has done some more testing.  Just make sure your son keeps getting checkups as much as needed and he should be fine.  Good luck to you all!