What to Do When Intraocular Pressure Is High and How to Relieve It

Good vision depends on healthy eyes; however, some patients may experience elevated intraocular pressure (IOP). So, what should be done—and how can it be alleviated—when IOP is high?

What to Do and How to Alleviate Elevated Intraocular Pressure

If IOP is found to be elevated, prompt consultation with an ophthalmologist is recommended for routine evaluation to determine whether the condition represents ocular hypertension or glaucoma. Diagnostic tests include gonioscopy, ultrasound biomicroscopy (UBM) or gonioscopy, visual field testing, fundus examination, central corneal thickness measurement, and 24-hour IOP monitoring. If glaucoma is confirmed as the underlying cause, immediate IOP-lowering treatment is essential to prevent irreversible damage to the optic nerve.

For primary glaucoma, treatment typically involves topical IOP-lowering eye drops and/or systemic medications. Topical agents include beta-blockers, adrenergic agonists, miotics, carbonic anhydrase inhibitors, and prostaglandin analogs—often used alone or in combination. Beta-blocker eye drops are commonly first-line therapy, though caution is warranted in patients with bradycardia. If target IOP cannot be achieved despite combination topical therapy, surgical intervention may be necessary. In cases of acute angle-closure glaucoma, emergency management includes topical medications plus systemic hyperosmotic agents.

In secondary glaucoma—such as that associated with corneal disease, iridocyclitis, lens-related conditions, trauma, corticosteroid use, or degenerative ocular disorders—the underlying cause must be addressed directly, and IOP-lowering eye drops may be used adjunctively as appropriate. We hope this information proves helpful to you!