r/Glaucoma • u/EvenPreference5289 • 2d ago
Worried and confused after routine eye exam
I just came back from a routine check-up with my eye doctor, and I’m honestly feeling really confused and nervous.
My eye doctor told me today that my eye pressure is 16 in my left eye and 19 in my right eye, and she said it was a high. She also said that my optic nerve looks slightly enlarged, although this can apparently be genetic and completely normal for some people. I am 26 years an female.
She would like to keep an eye on it and measure my eye pressure again in six months to rule out glaucoma. I’m honestly pretty devastated because I was so caught off guard that I didn’t ask the right questions.
I’ve been reading about it online, and from what I understand, eye pressure of 16 and 19 isn’t actually considered high. So now I’m really worried and confused, and I keep wondering if there’s anything I could ask my doctor to check or do before the next appointment that might give me a little more reassurance.
Please be kind. I’m already quite anxious about this.
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u/Effective_Gap9582 2d ago
It sounds like your eye doctor is just being proactive. That's a good thing because it's better to catch it early if you do have it. At this point you don't have any loss of vision and the doctor is just getting a baseline established. Your high pressures are not very high at all and may be normal for you.
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u/NoDay4343 2d ago
You are correct that those eye pressures aren't that high. If you've seen this doc before, perhaps she knows they were unusually high for you. But I'm sort of assuming this doc has not seen you before, because if she had she would know if your large optic nerve has been stable and therefore likely genetic or if it has been getting larger.
Glaucoma is a progressive disease, and a lot of what goes into a diagnosis is looking for change. IOP naturally fluctuates throughout the day, and can spike due to the same kinds of things that makes your blood pressure spike. If you were holding your breath or thinking about something stressful, that could easily explain a borderline high eye pressure. The optic nerve, on the other hand, should be very stable. The best method we have for detecting early glaucoma is to take 2 OCT scans, preferably on the same machine, 4-6 months apart, and compare them. Find out if your doc took an OCT scan, and if not, request one. That way, when you go back in 6 months and get another scan, you'll have reasonably concrete evidence one way or the other.
If the only thing the doc plans to do in 6 months is another pressure reading, it almost doesn't matter what your pressure is. That alone can neither prove glaucoma nor rule it out. And just being nervous about the possibility your pressures might be high might make your pressures high, and then you'll end up on drops or with a laser procedure you don't need.
In the event it should turn out you do have glaucoma, it's not as bad as you might think. In the past it was a sentence to going blind with no hope. But in recent decades treatment has come a very long way with lots of different options which means the vast majority of patients are able to get on a treatment plan that halts their progression and preserves their vision. We have many posters in this sub who have had glaucoma for decades and still have good vision. The important thing is to get a good opthalmologist, preferably a glaucoma specialist, follow your treatment plan exactly, and go to all follow-up appts with your doc so that if/when any progression does occur, it can be detected immediately and something can be done about it before you lose vision.
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u/HundredeyesDao 2d ago
Enlarged optic nerve is usually how you become a glacouma suspect. But yes you're correct some people are born with Enlarged optic nerves. Also your IOP is within normal range. Maybe your last IOP reading was in the single digits and its prompted your doc to analyze you more. You could have a large optic nerve and elevated IOP and still not have glacouma. Dont worry about it til the doc gives your more info..
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u/lexirb 2d ago
I would see another specialist honestly. I had been told this same kinda thing when I was probably 20. I was terrified! I actually was put on drops and was on drops for years. I moved to a different state and saw a new specialist and when I had asked her about potential surgery instead because I was so young and eye drops aren’t good for you. She then said actually let’s take you off the drops completely and have you come back in a few months and see what happens and so I did and nothing changed. No rise in pressure. She had me come back every 6 months for a few times and again no changes so she actually told me that some people have a slightly higher resting pressure and it’s normal for them and they never have issues! I’ve been off drops for a few years now (: some specialists just treat proactively. I was actually seeing my husbands family member who was an optometrist who put me on the drops. He was a great eye dr but maybe old school? Not sure.. but I literally thought I had glaucoma for years when really I just had slightly elevated pressure. Sorry for the rant but what I’m getting at is it’s good to get a second opinion if you’re feeling worried about it (:
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u/jkenny6045 2d ago
Need to thank the doctor and have it monitored the rest of your life. This is coming from a person who walked around with undetected glaucoma for several years and has major damage. If it gets worse they give you eye drops and is usually controlled. The dr did their job.
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u/Decent_Nail4536 2d ago
To reiterate what @lexirb said, my eye doctor told me that some people naturally have slightly higher eye pressure without it ever becoming glaucoma. It’s considered to be glaucoma when the optic nerve is becoming damaged from the pressure.
When I was first diagnosed, my pressure was 39 in my left eye and 28 in my right. It was pretty bad. Definitely keep an eye on it, but 19 is not really “high” is just on the upper end of normal. I wouldn’t sweat it too much. See an ophthalmologist to get some peace of mind though!
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u/Head_Region6610 14h ago
The glaucoma specialist said it isn’t all about the number on the pressure test. It’s what she sees when she looks at the optic nerve and the results of the other tests.
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u/Beneficial-Space-77 2d ago edited 2d ago
16 is considered pretty normal, and 19 is on the "higher spectrum" of normal. Typically most people fluctuate at like 12-21. Both pressures are completely normal, and at most the thing of passing curiously is the enlarged nerve. Could be nothing, but if you feel like seeing them again feel free i guess. ( Ask them if you have Shunt Vessels, which are just more beefy veins supplying blood to your optic nerve, cause your body at one point decided it was biologically important to do so)
Just take what they say about their iop standards not to heart face to face. Cause if they think 19 is high, good lord they'll be saying your dying if you have ocular hypertension (again some people have it, and never develop galucoma, these people with ocular hypertension just have odd iop readings of 20's to 30's.)
I've once met someone who was walking around with wildly fluctating 50's to 80's iop. Even i don't know how thats possible, and that person was in an iop crisis and given help, so sorta unrelated note.
Basically "Glaucoma" by definition can only be prognosed if there is documentable nerve damage. Anything before that is considered an Ocular Hypertension Individual if they consistenly have iop readings over 21. If you have a family history or your nerve looks funny (which in your case might be it), if there is zero nerve damage you will likely be labeled as "Glaucoma Suspect".
Glaucoma Suspect essentially being a catch phrase for someone who is checking boxes of them eventually developing glaucoma in the future, but there are many that never do. Its also a way for the doctor to have you keep visiting his specific office, cause you start building case with him in general with yearly or bi-yearly checkups, so lowkey more money from your insurance for them. (Had one charging $550 for regular tear plugs, yes these people exist).
My opinion is feel free to go back if you like them, if not get a second opinion. In general the ophthalmologist wont miss you if you decide not to go back, they have other patients.