Blood pressure plays a significant and complex role in the development of glaucoma and its progression. Strangely enough, both high and low blood pressure levels can contribute to these risks. Learn more about the connections between blood pressure, eye pressure, and glaucoma, and what you need to tell your doctors in order to preserve your sight.*

High blood pressure

Also called hypertension, high blood pressure can increase the pressure inside your eye, potentially raising the risk of glaucoma, though your blood pressure would need to increase by approximately 10 mmHg (millimeters of mercury) to raise your intraocular (interior eye) pressure, also known as IOP, by 0.26 mmHG. 

Long-term high blood pressure can also cause damage to the retina and lead to hypertensive retinopathy, an eye condition that, like glaucoma, often has no symptoms until it is advanced and irreversible vision loss has occurred.

Lastly, elevated blood pressure is also a concern because it increases your likelihood of developing heart disease and/or experiencing a stroke. Both of these must be effectively managed as serious health events in their own right, but they can also hinder blood flow to your eyes, which can negatively impact your vision. 

Low blood pressure

Conversely, low blood pressure (hypotension) can also pose a risk for glaucoma by reducing necessary blood flow to the eyes. A certain amount of blood must regularly reach each eye to nourish it and maintain optic nerve health. The risk of low blood pressure can occur naturally or be due to an excess of medication used to treat high blood pressure.

It’s crucial to discuss your blood pressure issues and concerns with both your primary care physician and ophthalmologist, especially if you’re undergoing glaucoma treatment. This ensures appropriate management, and avoids potential interactions between glaucoma medications and blood pressure treatments. 

Speak with your healthcare team

Because both hypertension and hypotension are glaucoma risk factors, it’s important to speak with both your primary care physician and your ophthalmologist about:

• Your blood pressure, 
• Your eye pressure, and
• How both are being managed. 

One commonly-used glaucoma medication is a beta-blocker eye drop. Oral beta-blockers are frequently used to treat high blood pressure. In addition to lowering blood pressure, beta-blockers can reduce your heart rate. Simultaneous use of these two medications, therefore, can potentially cause unwelcome, and even dangerous, results. 

If you have underlying health conditions, such as kidney problems, consult with your healthcare providers regarding its impact on your eye health. Dialysis for kidney failure can cause your blood pressure to fluctuate. Your nephrologist may be able to adjust your dialysis protocol to protect your optic nerve.

Blood pressure also naturally dips at night. Both blood pressure and eye pressure vary over the course of the day, and in situations where blood pressure drops and eye pressure increases overnight, damage to the optic nerve can occur.

Most importantly, be sure to voice any questions or concerns you have about your blood pressure’s impact on your eye health. Self-advocacy can go far to improve your overall health outcomes.

*Ou, Y. (2021, July 7). Blood Pressure and Glaucoma. BrightFocus Foundation. https://www.brightfocus.org/glaucoma/article/blood-pressure-and-glaucoma#:~ 

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