Ophthalmology & Optometry/Eye Pressure


Hi Dr. Dovie!

45-F.  Since the past few weeks, I have been feeling what feels like eye pressure (pressure above / behind) my eyes.  Also, difficulty reading fine print.  I got an eye exam completed, and the Dr. recommended some over-the-counter reading glasses (1.25+) for the reading issues.  

However, my question pertains to the eye pressure.  The Dr. said they would take a baseline measurement for now and then another one in four months to check if there is any difference (in the canal, I think they said...?).  In the meantime, they recommended eye massages, flax-seed oil, eye drops, pain killers etc.

I'm getting concerned about it since it appears to affect me nearly everyday now - not severe, but enough to be noticeable.  

Not sure what my question is, but does it sound we're on the right track?  Is there anything else I could be doing in the meantime so this doesn't get out of hand?  Any advice?

Thanks in advance!

I would get another opinion.  The 'pressure' you're feeling is likely related to a vision problem that's not being addressed, not the actualy pressure inside your eye.  IOP, or intraocular pressure, is what we measure for glaucoma and other disease.  Unless this pressure is sky-high because of uncontrolled glaucoma, etc, there is no feeling to it - it doesn't hurt or radiate any sensations.
Pain in and around the eyes, 'pressure,' etc, are usually from one of two things: the accomodative (focusing) system being unbalance, fatigued, or overworked.  Or, the extraocular muscles, the 'targetting' system, being out of balance.  Many people, especially in their 40s, have a hard time compensating for small muscle misalignments which they may have been living with for years.  This is what it sounds like to me.
It's obviously difficult to tell without a physical exam, but I think you need just that - another exam.  Make sure they do muscle and balance testing for your eyes (including things like cover test and phorias), and look for small refractive errors, like subtle astigmatism.
Good Luck!

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John M. Dovie, OD, FAAO


As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.


Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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