Eye pressure

[Samantha1200]

I’m a 21 year old guy,  eye appears all healthy. I saw a optometrist who measured pressure using a machine puff test, it was L 20 R 22. She said don’t worry your cornea is thick (575-585) maybe abit lower. Today I went to a retina specialist, his assistant or trainee measured it same exact time of day with the hand held puff test and it was 27 in both eyes. He said he than scaled it with my cornea and said it’s slightly high and nothing to worry about and referred me to a glaucoma specialist after I said I think I’m getting mixed messages, is it scaled properly - is it high or low, why are two different machines measuring different, why didn’t he measure me and not his trainee. I’m very confused I know he said it looks all well but I’m waiting a month to know for sure, John Hagan MD what is your opinion does this sound accurate to you?

[Samantha1200]

Thankyou is this a common thing you’ve come across with people my age considering my pressure / thickness? Sorry my last reply was jumbled with phone

[JohnHaganMD]

I have a very large glaucoma practice. This is something I see weekly, referrals usually come from commercial opticals like Lenscrafters,  etc.   Biggest questions is "Do I have glaucoma? Do I need treatment? If not how should my eyes be followed"

[Samantha1200]

Thankyou, is it true that even if you have a high pressure of 30 with 600 cornea thickness, for example but thick cornea it doesn’t give you a higher chance than someone who has a high reading of 20 but cornea thickness of 500

[JohnHaganMD]

Stop there, you are going in a circle.  Glaucoma is not one but many diseases, extremely complex, the risk depends on many things: family history, age,  refractive error, corneal thickness, optic nerve morphology, systemic illnesses, race, etc.  Calm down till you have your glaucoma consult.

[Samantha1200]

Thankyou, is what I’m saying a common thing peoplemt age experience or is that a odd case conserving my pressure:thickness

[JohnHaganMD]

The IOP varies from hour to hour. There is also a subjective component  (skill of tester, whether patient squeezes or not).  Your cornea is thicker than normal. There are several 'cheat sheets" used to change a goldman tonometer reading to true inside IOP based on thick/thin cornea. Your cornea will subtract numbers.  I would suggest you see an Eye MD specializing in glaucoma. I think it unlikely you have glaucoma. Most likely the glaucoma specialist will do some tests to reassure not a problem at this time.   This is an everyday situation in ophthalmology.  Eye MDs don't measure IOP techs do because they do a great job and there are so many patients versus number of physicians that tests and parts of the exam that can be done by techs have to be done by techs. Otherwise if Eye MD did everything could only see about 6 patients per day and waits would be untenable and costs unbearable.