Blood pressure and eye pressure vary independently. Controlling blood pressure does not mean IOP is controlled. But studies have shown that patients with high blood pressure have an increased risk for glaucoma. Very high blood pressure is not good for glaucoma.
Moderate to very low blood pressure is also a problem because it is important for the optic nerve to receive sufficient blood flow. Evidence suggests that low ocular perfusion pressure is a strong risk factor for glaucoma. Ocular perfusion pressure is a complex variable that can be considered as the difference between the blood pressure and the eye pressure. If the blood pressure is low and the eye pressure is elevated, blood has difficulty getting into the eye to supply oxygen and important nutrients.
Patients who are taking medication for high blood pressure may actually have their blood pressures dropping to very low levels during the hours they are sleeping. This reduces the amount of blood flow to the eye and optic nerve and may compromise the optic nerve. The role of blood flow in optic nerve damage is the subject of ongoing study. We now understand that in some forms of glaucoma, there is a strong link between glaucoma and reduced blood flow to the optic nerve.
Patients with any progressive glaucoma need to make sure their blood pressure is not dropping to very low levels while they sleep. Both blood pressure and eye pressure vary over the course of the day. Blood pressure naturally dips at night while eye pressure often increases. In situations where blood pressure drops and eye pressure increases overnight, damage to the optic nerve could be occurring.
Your eye care professional needs to know about all your medical conditions and the medications you are taking and needs to work with your other doctors to make sure everything is in synch.
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