pressure concerns

[abhi_1122]

I will break my matter into two questions, request you to answer individually
Q1:- we all know that high eye pressure in open angle glaucoma is usually painless , however I want to know that people who are hit with a ball or stone in the eye and develop bleeding in eye or inflammation ( these things can clog drainage canals and raise pressure ). Then the pain which patient experiences is due to the underlying trauma/hyphema/inflammation or its rather from the pressure in such cases?
Q2.: On my last visit to hospital , my eye pressure came out to be 25 in both eyes via the air puff test . Since i got concerned, i informed senior resident of opthalmology and he asked the junior resident girl there to take pressure with applanation tonometer method. the junior resident did put anaesthetic drop into the eye so that i dont blink while the tonometer touches, but she did not use any fluroscein strip at all. I even confirmed with her and she said that without fluroscein use , results are more accurate ! ..IS IT TRUE AT ALL? my readings came 14 and 16 ....are these reliable in this case? because previously i have seen every experienced opthalmologist using orange dye into dye.

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

Question 1:  Right after the injury the pain can be due to a number of things pressure, inflammation,  infection.  Pain just from pressure is often related to how fast it goes. In other words a intraocular pressure (IOP) of 30 is likely painful if  the pressure increases quickly over  several hours like angle closure, surgery or trauma. But 40 might not be painful if increase is over months like open angle glaucoma
Question 2  No the test is not more accurate without fluorescein dye.  Sometimes when I double check a technician I will not put extra dye in because there is still some dye from when tech tested. If  I can't see the dye (which is yellow under the blue light) I put more in.

[abhi_1122]

But will my readings of 14 and 16 be reliable in this case? Or it has been understated while recording and by how much... Is my pressure within normal range. Or I have to go again for repeat testing with fluroscene ....I was wondering if their professor taught them in a different way.

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

Any IOP reading is only worth the skill and attentiveness of the person doing the testing.  You need to discuss your concerns with your ophthalmologist.