What Causes Ocular Hypertension And Why It Can Lead To Glaucoma

Jan 03, 2022
 – Eduardo Besser, MD
  • Eye Health

Learn about ocular hypertension. Find out what causes ocular hypertension, its risks, and how it can be treated in our clinic.

January is Glaucoma Awareness Month, and today we’ll be talking about the causes and risks of ocular hypertension and how it can lead to glaucoma.

Ocular hypertension is a condition in which the eye's pressure is higher than normal. Most commonly, the cause for the increased pressure is not identified, however it may be due to ailments such as diabetes or high blood pressure. It affects people over 40 — or those with a family precedent.

High eye pressure can lead to serious problems like glaucoma, causing significant vision loss and blindness. Some patients may have Ocular hypertension that does not progress to optic nerve damage or glaucoma, and may not require treatment. Close follow up and guidance from your doctor is important in order to preserve your vision.

What causes ocular hypertension?

Some people are at higher risk of developing ophthalmic hypertension than others. The most common factors are being over 40 years old, having a family history of it, being African-American, and having high blood pressure.

Other factors include:

Increased production of eye fluid

High eye pressure is oftentimes caused by an increased production and accumulation of the eye's fluid, called aqueous humor.

Insufficient drainage

Ocular hypertension also can occur if the aqueous is produced at a normal rate but drains too slowly from the eye.

Eye injury

Eye trauma is another factor that may raise ocular pressure. Sometimes ophthalmic hypertension can occur months or years after the injury.

Underlying conditions

Diabetes, high blood pressure, and myopia are all factors that can cause elevated ocular hypertension.


Long-term steroid intake.

What are the symptoms of ocular hypertension?

Ocular hypertension increases pressure inside the eye, usually without any symptoms. People who have it might not feel it because their eyesight seems fine.

The process of ocular hypertension leading to glaucoma is gradual. When the pressure inside your eye increases, it leads to damage of the optic nerve, in charge of sending information from your retina to your brain.

High eye pressure is dangerous because it often develops slowly, and people may not notice any signs until it's too late. In the worst cases, this damage can lead to vision loss or blindness even before patients know they have ocular hypertension.

The only way to detect high ocular pressure is through regular eye exams. If you are diagnosed with it, your eye doctor will monitor your eyesight by measuring your eye pressure.

Types of glaucoma

Glaucoma is the second leading cause of blindness in America. There are two main types: open-angle and angle-closure.

Open-angle glaucoma

This is the most common type of glaucoma, usually not presenting any symptoms in its early stages. In open-angle glaucoma, there's a gradual increase of the fluid inside the eye called the aqueous humor, which in turn causes a rise in pressure. Symptoms may include blurred vision, gradual loss of peripheral vision, or faded colors.

Angle-closure glaucoma

Closed-angle glaucoma can show up with a sudden, severe pain behind your eye, nausea, vomiting, double vision, or loss of peripheral or side vision.

Early detection can prevent blindness from developing in both types of glaucoma.

What causes ocular hypertension

How is ocular hypertension treated?

Treatment for ocular hypertension varies depending on the severity of your condition. If there is no damage to the optic nerve, your ophthalmologist may elect to monitor you periodically without treatment. If there is damage to the optic nerve, your doctor will recommend taking medication daily. The goal is to decrease the pressure inside your eye so it doesn’t lead to glaucoma.

High eye pressure can be treated with medications like beta-blockers, alpha-agonists, and prostaglandin analogs (PGAs). These medications help lower the pressure in your eyes.

In our office, patients with open-angle glaucoma can be treated with Selective Laser Trabeculoplasty (SLT). This device is used to lower pressure in the eye in a fast, effective, and painless procedure that creates less scar tissue than other techniques.

Dr. Besser also performs MIGS which refers to Minimally Invasive Glaucoma Surgery. The procedure is done with the help of microscopic equipment and tiny incisions. Like SLT, MIGS is generally recommended for mild or moderate glaucoma patients.

This procedure is not suitable for severe cases or patients who have had multiple failed glaucoma surgeries in the past.


If your ophthalmologist diagnoses you with ocular hypertension, they will do regular eye exams to monitor any changes in your eyesight to help predict if you are at risk of developing glaucoma. Depending on your particular case, they might prescribe medication or recommend surgery.

When visiting our facility in Culver City, California, you can expect superlative medical care. Dr. Besser works closely with each patient and customizes treatment based on their needs. All our patients are thoroughly evaluated, carefully monitored, and reviewed frequently to follow their progress, and modify the treatment if needed to ensure the best outcomes.

If you are concerned about your eyes’ health, call our office today. We’re happy to help you understand more about what causes ocular hypertension and its associated risks, and will book you for a consultation.


If you are concerned about your eyes’ health, call our office today. We’re happy to help you understand more about what causes ocular hypertension and its associated risks, and will book you for a consultation.

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