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Ocular hypertension is the presence of elevated fluid pressure inside the eye (intraocular pressure), usually with no optic nerve damage or visual field loss. [1] [2]For most individuals, the normal range of intraocular pressure is between 10 mmHg and 21 mmHg. [3]
Intraocular pressure varies throughout the night and day. The diurnal variation for normal eyes is between 3 and 6 mmHg and the variation may increase in glaucomatous eyes. During the night, intraocular pressure may not decrease [17] despite the slower production of aqueous humour. [18]
For eye pressures, a value of 28 hPa (21 mmHg) above atmospheric pressure 1,010 hPa (760 mmHg) is often used, with higher pressures leading to a greater risk. [2] [26] However, some may have high eye pressure for years and never develop damage. [2] Conversely, optic nerve damage may occur with normal pressure, known as normal-tension glaucoma. [27]
Impression tonometry (also known as indentation tonometry) measures the depth of corneal indentation made by a small plunger carrying a known weight. The higher the intraocular pressure, the harder it is to push against and indent the cornea. For very high levels of IOP, extra weights can be added to make the plunger push harder. [14]
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A good analogy to better understand the cup-to-disc ratio is the ratio of a donut hole to a donut. The hole represents the cup and the surrounding area the disc. If the cup fills 1/10 of the disc, the ratio will be 0.1. If it fills 7/10 of the disc, the ratio is 0.7. The normal cup-to-disc ratio is less than 0.5.
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