24 year old with iop of 18-22 on average for every yearly visit the last 5 years?

[Spartan114]

Isn’t that much higher than the average for my age?

No glaucoma I know of. Do yearly eye exams with dilation. My pressures are as follows the last 5 years 18/19 20/19 17/22 17/21 20/19 20/22 (went twice one year)

I’m just very concerned here. I keep reading that eye pressures are normally below 20 and for young people the average is more like 12-14. I’m so far above that though.

Should I be asking more about this?

[John C Hagan III, MD, FACS, FAAO]

The short answer is yes. The longer answer is:  1. you need to be seeing an Eye MD ophthalmologist not a non-physician optometrist.  2. You need parameters other than just your IOP including family history (do you have a blood relative with glaucoma? If so you are a glaucoma suspect), your cup/disk ration, a baseline visual field, a baseline macula and nerve fiber layer OCT, a measurement of corneal thickness (pachymetry) and possibly a gonioscopy.   IOP alone is not a way of diagnosing glaucoma.

[Spartan114]

I do see an an ophthalmologist, he does dilated exams every year. No OCT but he may be checking for the disc ratio or the other factors through his exam. He does a pretty comprehensive workup and I know he said my nerves look very healthy.

The reason I see him every year is due to childhood eye surgery, I had mild cataracts as a child, now they found the gene responsible and can definitely say that the gene is only know to cause cataracts (no systemic issues and no glaucoma association) as it’s a more common CRYAA mutation. My surgery was at 4 years of age going on 5 so I know I dodged the major risk presented in surgery before a year old. Implanted IOL so was never aphakic

Still I know that gives me an increased risk factor for glaucoma. I guess I’m just confused, are my pressures higher than normal for my eyes? My ophthalmologist keeps saying that 10-22 is normal and that I’m within that range so he’s not worried. I know they say Icare and puff tests (what they have used) are very prone to overestimating a couple points. Every time I ask him about it he says I’m not a glaucoma suspect by any means but I take it you think my pressures are concerning?

[John C Hagan III, MD, FACS, FAAO]

The range of IOP you quoted is what most surgeons use.  I suggest you discuss with your ophthalmologist next time. Ask what your cup/disc ration is. Should be .4 or less. I would ask that he perform a nerve fiber layer and macula OCT, not expensive and gives a wealth of information. Should also measure at least one time corneal thickness. If you have a very THIN cornea than the IOP is more troublesome, if THICK cornea less troubling.  So at this point, you need to discuss with your eye MD.

[Spartan114]

By ‘range surgeons use’ what do you mean? You mean my pressures are abnormally high if taken alone? In your opinion is that unusually high for a young person? Or are numbers in the high normal common in all ages?

[John C Hagan III, MD, FACS, FAAO]

Spartan, I'm signing off.  You have enough information to evaluate your situation.

[Spartan114]

I appreciate your input but I’m just confused, if my iop is within normal why would more testing be necessary? That implies to me my iop is very much not normal

[John C Hagan III, MD, FACS, FAAO]

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