Eye pressure test

Overview

An eye pressure test is a quick and painless check that measures the pressure inside your eyes. High pressure can be a sign of glaucoma, a condition that can damage your sight. The test is also called tonometry.

Yes, an eye pressure test is a standard part of eye exams for adults, especially those over 40.

Anyone can need an eye pressure test, but it is especially important for people over 40, those with a family history of glaucoma, people of African or Caribbean heritage, and those with certain medical conditions like diabetes.

Symptoms

Common symptoms

• The eye pressure test itself has no symptoms – it is a screening test.
• High eye pressure usually has no symptoms until advanced glaucoma develops.
• Later signs of glaucoma may include blurred vision, seeing halos around lights, or loss of side (peripheral) vision.

Symptoms in children

• Children rarely need an eye pressure test unless there are signs like cloudy eyes, excessive tearing, or light sensitivity.
• Children born with glaucoma may have enlarged eyes, cloudy corneas, and squinting.

Symptoms in older adults

• Older adults are more likely to have high eye pressure and should have regular tests.
• Vision changes like reduced peripheral vision or difficulty seeing in low light can be signs of glaucoma.

Causes

Main causes

• The test is used to find high eye pressure, which often has no clear cause.
• It can be part of primary open-angle glaucoma, where the eye's drainage system becomes less efficient over time.
• Other types include angle-closure glaucoma, where the iris blocks drainage suddenly.

Risk factors

• Age over 40
• Family history of glaucoma
• Being of African, Caribbean, or Asian heritage
• Having diabetes, high blood pressure, or severe nearsightedness
• Previous eye injury or surgery
• Long-term use of steroid medications

When to see a doctor

See a doctor urgently if:

• Sudden eye pain or severe headache with vision changes
• Seeing halos around lights or suddenly blurred vision
• Nausea or vomiting with eye pain

Book a routine appointment if:

• Routine eye exams every 1–2 years for adults over 40
• Sooner if you have risk factors like family history or diabetes
• Any time you notice vision changes – make an appointment with an optometrist or ophthalmologist

Diagnosis

An eye pressure test is part of a comprehensive eye exam. It is often done along with other tests to check the health of your optic nerve and your field of vision.

Tests that may be done

• Tonometry: The main test for eye pressure. It can be done with a puff of air (non-contact tonometry) or by gently touching the eye with a numbing drop and a small device (Goldman tonometry).
• Pachymetry: Measures the thickness of your cornea, which can affect pressure readings.
• Ophthalmoscopy: Your doctor looks at your optic nerve through a magnifying lens.
• Perimetry: A visual field test to check for gaps in your side vision.
• Optical coherence tomography (OCT): A scan that gives a detailed image of your optic nerve and retina.

What to expect at your appointment

You will not need any special preparation. The test is done in the office. You may feel a light touch or a quick puff of air. If drops are used, they may make your vision blurry for a few hours, so bring sunglasses and avoid driving until the drops wear off.

Treatment

If your eye pressure is high and you have signs of glaucoma, treatment aims to lower the pressure and protect your optic nerve. Treatment is often lifelong and can include eye drops, laser treatment, or surgery.

Self-care at home

• Take all medication exactly as prescribed, even if you feel fine.
• Attend all follow-up appointments to monitor your eye pressure.
• Tell your eye doctor about any other medications you use, especially steroid medicines.

Medical treatments

Eye drops are the most common first treatment. They help reduce fluid production in the eye or improve drainage. Your doctor may also recommend laser therapy to open the drainage channels. Oral medications are sometimes used if drops are not enough.

When is surgery considered?

Surgery may be considered if medication and laser do not control the pressure. Procedures like trabeculectomy create a new drainage channel, or implants (tubes) can help drain fluid.

Living with this condition

If you have glaucoma or high eye pressure, you can still live normally. You will need regular check-ups and to use eye drops as directed. Most people do not experience pain or discomfort.

Lifestyle tips

• Protect your eyes from injury – wear safety glasses during sports or DIY.
• Avoid heavy lifting or activities that involve straining, as this can temporarily raise eye pressure.
• Take breaks if you do close work or use screens for long periods.

Diet and exercise

A healthy diet and regular exercise are good for overall health, but no specific diet or exercise can cure glaucoma. Some studies suggest drinking plenty of water and avoiding large amounts of caffeine may help, but follow your doctor's advice.

Mental health and emotional wellbeing

A diagnosis of glaucoma can be worrying, but remember that vision loss is preventable with early treatment. Many people manage well with treatment and continue normal activities. Talk to your doctor if you feel anxious or depressed.

Prevention

Most cases of high eye pressure and glaucoma cannot be prevented, but regular eye pressure tests can catch it early to prevent vision loss. Avoid injury to your eyes and manage health conditions like diabetes.

Screening programmes

Adults over 40 should have a routine eye exam every 1–2 years. People at higher risk may need more frequent tests. The eye pressure test is the key screening tool.

Complications

If left untreated

• High eye pressure that is untreated can lead to glaucoma and permanent vision loss.
• Vision loss usually starts in the side (peripheral) vision and may go unnoticed until advanced stages.
• Once lost, vision cannot be restored, which is why early detection is so important.

Long-term outlook

With early detection and proper treatment, most people with high eye pressure or glaucoma can preserve their sight for life. The eye pressure test is a simple and effective way to protect your vision.

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