Q: I heard that drinking coffee can raise your eye pressure and make glaucoma worse. Is that true?

A: For some time it was felt that drinking coffee could raise the pressure inside the eye and aggravate glaucoma. Recently a study was done that specifically looked at that question, and the answer was, “yes and no.” The study found that drinking coffee does indeed raise the pressure inside the eye, but only for patients with glaucoma. If you do not have glaucoma, drinking coffee has little effect on your intraocular pressure.

Glaucoma patients take medication to reduce intraocular pressure, and the difference of two or three points can be significant. For them, drinking coffee has the potential to raise the amount of medication they take or even result in the need for surgery. As a result of the knowledge gained from this new study, we can now discuss coffee consumption with our glaucoma patients and potentially enhance the control of the disease.

Q: My eye doctor says I may have glaucoma, but that my eye pressure readings are normal. Is that possible?

A: Unfortunately yes. Glaucoma is not a single disease, but instead a group of related conditions that all cause a similar type of damage to the head of the optic nerve, resulting in blindness. There are no symptoms as the damage slowly progresses, so patients may lose much of their vision before they realize something is wrong. Though many patients associate glaucoma with high eye pressure, about one-third of glaucoma cases have normal pressure. This means the old screening test that measures pressure is not a reliable test, since it will miss many patients who do in fact have glaucoma. To do a thorough test for glaucoma it is necessary to dilate the pupils of the eye in order to use special instruments to examine the optic nerve. The only reliable way to detect glaucoma is a regular eye examination with dilation.

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