High pressure in eyes-how high is too high?

[Tiggiwinkle]

I know there are several "eye experts" who post on the site sometimes, and am just needing a bit of reassurance, please.
I had a yearly eye test this week and the optician said the pressure in both eyes was a little high. It was 23. He said they would re-test when I picked up my glasses, which they did -and it was still 23. However, he said this was not a problem-but they will check it again in a years time.
I have suffered with iritis (or uveitis as is is now more usually known, I think) quite a few times over the years, and know this makes me more at risk of glaucoma-so is the pressure OK or should I get further advice?

Not an eye expert, just a fellow iritis sufferer.

I think the normal range is between 10 - 21 but there is a variance and some people can tolerate higher pressures. Mine was also 23 last time I had it checked, but I had just had an iritis episode. The consultant didn't seemed overly bothered.

tiggiwinkle, anything over 21 is considered "high". Now, having said that, you can have high pressure without having glaucoma. ( You can also have glaucoma without having high pressures but that's another story!)
There are three "tests" for glaucoma. The first is ophthalmoscopy, routinely done at every eye test, where a light is shone into the eye. If the optic nerve looks normal its less likely that you would have glaucoma.
The second test is to check the eye pressures as was done in your case.
The third test is a visual field test. This involves checking the peripheral vision. Usually this involves the patient looking at a central target, while being shown lights or objects in the periphery. A failure to pick up something in the periphery indicates that there is a visual field loss.
Now, most eye specialists would agree that if the visual fields are normal, then you do not have glaucoma, irrespective of whether the eye pressures are high or whether the optic nerve looks normal.
As a general rule, I would only refer someone whose eye pressures were 23 if there was a visual field loss. I always refer if the eye pressures are 25 or over. If your optician feels that other than the eye pressure all is fine then waiting for a year is fine in theory though in our practice my colleagues and I usually ask people to come back in 6 months. HTH

Just found \link{http://health.yahoo.com/topic/vision/overview/article/mayoclinic/12EB8700-E8C8-4FE6-A2429E6F33CCB0E8\this} which looks like a very informative site.

The way I understand it from there is that pressure of 23 in one eye is more of a cause for concern. Assuming you are 23 in both it may be that your pressures are just higher due to the iritis. Regular checks seems to be the answer.

Hopefully a genuine expert will pop along soon!

" Hopefully a genuine expert will pop along soon! "

Oops . Cross posted chipmonkey, not saying you're not an expert.

Many thanks for the replies, chipmonkey and saintgeorge.
I had the test at Specsavers and it included a visual field loss test (you had to focus in the middle and press a button every time you saw a wriggly line around the screen-thats the one, isn't it?) I guess it should be OK to wait then, as everything else was normal.

Yes, that's one of them! If that's clear, then no need to worry, just remember to go back for the follow-ups.

Thanks for the link Saintgeorge -lots of useful info there.

I've stuck it in my favourites to study later

Nothing like a little swotting to keep the brain cells alive SaintGeorge!

Too late, brain cells fried a long time ago. This is purely for my own benefit. Eye clinic consultants are not always the most forthcoming with information.

Very true. They tend to be rushed and are in and out before you have time to ask anything!

Chipmonkey-Can I be a nuisance and ask one more thing? The opticians said I was to go back within the year if I were to experience any floaters, pain etc in the eyes.
Now, in addition to the usual black floaters which I think everyone experiences from time to time, I do get small "lines" of light on the periphery of my vision sometimes. They each last for a few seconds,in bouts of a few minutes in all. Stupidly, I did not mention them as they are one of those things you forget about until they actually happen again. (they are completely different to the flashing zigzags of migraine aura which I also suffer from, and which last continually for 20 minutes or so).
Are they something I should be concerned about? (I have been having these "bright" floaters for at least a year now.)

Tiggiwinkle they don't sound like the sort of flashing lights we'd get worried about. There wouldn't be any pattern to those, just a quick flash and its over. It sounds more like migraine although clearly not the type that you usually get! Do the occur on both sides of your vision or just one.

Chipmonkey-They are in the top half of my vision, at the top edge and down the side. I seem to notice them most in my right eye, but could not say for sure that they are only in that eye. The "attacks" are very short lived and I have not noticed any particular trigger.

Tiggiwinkle, just erring on the side of caution I would ask for another appointment to have this checked out. What you're describing could be another form of migraine or a circulation issue but because they're short-lived and with your history it might be better to have it checked out, preferably with a dilated examination so the peripheral retina can be checked.

Chipmonkey-I have a nagging doubt about it I must admit. I really don't know why I didn't think to mention it at the time, because every time I get them I wonder what they are. Can the optician do the kind of test you mention? (And thanks again for the help, by the way).

Yes, we can all do a dilated examination. You should probably ask for it when you make the appointment as the optician would need to allow time for the pupil to dilate, and also remember that your pupils would remain dilated for quite a while afterwards so a pair of sunglasses is a good idea. Also you would not be able to drive immediately so it would be better to bring someone with you if you need to be driven home. Usually by the next morning you would be back to normal.

Thanks Chipmonkey. I will arrange it for when the DSs are back at school-I can go on my own then.