Ophthalmology

Hypersecretion Glaucoma: A Patient Guide

At a Glance

Hypersecretion glaucoma is a historical term for high eye pressure thought to come from excess fluid production. Today, ophthalmologists usually look for drainage problems or other causes and lower pressure with medicines, laser, or surgery to protect vision.

The term hypersecretion glaucoma is a historical label used to describe a theory that the eye’s pressure rises because it produces too much fluid, rather than the more common problem where the fluid cannot drain out correctly. In the “faucet and drain” analogy of the eye, this diagnosis suggested the faucet was turned up too high ^[1]. While this term has largely fallen out of favor in modern ophthalmology, the high eye pressure it describes is a very real clinical finding that requires careful management to protect your vision ^[2]^[3].

It is important to understand what this means for you:

Ocular Hypertension: High eye pressure with no detectable damage to the optic nerve.
Glaucoma: High eye pressure that has caused characteristic damage to the optic nerve or visual field.
Not everyone with high pressure has glaucoma, but high pressure is the main risk factor for developing it.

In contemporary medicine, doctors recognize that nearly all cases of high eye pressure involve a problem with fluid leaving the eye rather than how much is being made. When a patient has high pressure but the “drainage angle” appears open, it is often due to microscopic resistance in the drainage system or a backup in the veins downstream ^[2]^[4]. Because the label of hypersecretion is considered controversial, your doctor will look for “look-alike” conditions that may be the true cause of the high pressure ^[5].

These look-alikes include conditions like steroid-induced glaucoma, where past or current steroid use causes the eye’s drain to function less efficiently, or elevated episcleral venous pressure, where a vascular backup prevents fluid from exiting the eye ^[6]^[7]. In uncommon but urgent cases, high pressure combined with specific symptoms (like a bulging eye, double vision, or a whooshing sound) can be a sign of a carotid-cavernous fistula, an abnormal blood vessel connection behind the eye ^[8]. These rare vascular conditions require specialized evaluation, though most patients with high pressure do not have them.

Regardless of the label used, modern treatments are highly effective at lowering intraocular pressure to a safe level. This is typically achieved through medications, lasers, or surgery that either “turn down the faucet” (reducing fluid production) or “open the drain” (enhancing outflow) ^[9]^[10].

While most glaucoma is a “silent” condition with no early symptoms, certain red flags—such as sudden severe eye pain, sudden vision loss, or rapid eye swelling—require immediate emergency medical attention ^[11]. By working with your care team to find your target pressure, you can effectively manage this condition and protect your sight for the long term ^[12].

In this guide

6 chapters

Understanding the Term 'Hypersecretion Glaucoma'

Learn what hypersecretion glaucoma means, why it is considered a historical term, and how doctors assess eye pressure, ocular hypertension, and glaucoma.

Why Your Eye Pressure Is High: Faucets, Drains, and Backed-Up Pipes

Learn why high eye pressure labeled as hypersecretion glaucoma often reflects poor drainage, steroid effects, or venous pressure, and how doctors investigate it.

Warning Signs: When High Pressure Becomes Urgent

Learn which hypersecretion glaucoma warning signs need emergency care, including severe pain, halos, cloudy vision, fixed pupils, and sudden vision loss.

Decoding Your Diagnostic Tests: Faucets, Drains, and Maps

Learn how doctors evaluate hypersecretion glaucoma with tonometry, gonioscopy, OCT, visual fields, pachymetry, and specialized imaging for secondary causes.

The Path to Lower Pressure: Medications, Lasers, and Surgery

Learn how hypersecretion glaucoma is treated with eye drops, laser procedures, surgery, and root-cause care while lowering pressure and protecting vision.

Your Long-Term Journey: Building a Team and Living Well

Learn how to manage hypersecretion glaucoma long term: find specialists, plan monitoring visits, exercise safely, use eye drops, and address scan anxiety.

Common questions in this guide

What does hypersecretion glaucoma mean?

Hypersecretion glaucoma is a historical term for high pressure inside the eye that was thought to be caused by making too much eye fluid. Modern eye specialists usually look for reduced drainage or another cause, such as steroid exposure or a problem with nearby blood vessels.

Is high eye pressure the same as glaucoma?

No. Ocular hypertension means the pressure is high but there is no detectable damage to the optic nerve, while glaucoma means there is characteristic damage to the optic nerve or the field of vision. High pressure increases the risk of glaucoma, so follow-up is important.

Can steroid medicines cause high eye pressure?

Yes. Steroids can make the eye’s drainage system work less efficiently and may raise pressure; this can happen with prescribed or over-the-counter products, including inhalers, nasal sprays, and skin creams. Tell your eye doctor about all steroid use rather than stopping a prescribed medicine on your own.

What warning signs of high eye pressure need emergency care?

Most glaucoma has no early symptoms, but sudden severe eye pain, sudden vision loss, or rapid swelling around the eye needs immediate emergency evaluation. A bulging eye, double vision, or a rhythmic whooshing sound also warrants prompt medical attention because these signs can point to a rare problem involving blood vessels behind the eye.

How is hypersecretion glaucoma or high eye pressure treated?

Treatment is chosen based on the cause and target pressure. Eye-pressure medicines may reduce fluid production or improve drainage, and laser treatment or surgery may be considered when needed to protect the optic nerve and vision.

Curated prompts to bring to your next appointment.

1.Based on my exam, do we have evidence that my eye's 'drain' (outflow) is working normally, or is the 'hypersecretion' label primarily a historical way of describing my high pressure?
2.Are there specific signs on the white of my eye, like 'corkscrew' blood vessels, that suggest my high pressure is a vascular backup rather than a production issue?
3.Could any of my past or current medications, especially steroids like inhalers or creams, be the actual cause of my high eye pressure?
4.Since we're focusing on lowering pressure, is it better for my specific case to 'turn down the faucet' with production-reducing drops or 'open the drain' with outflow-enhancing drops?

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References (12)

1
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2
The aqueous humor outflow pathways in glaucoma: A unifying concept of disease mechanisms and causative treatment.
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3
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4
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5
[Glaucoma due to elevated episcleral venous pressure].
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6
[Secondary open-angle glaucoma: uveitic secondary glaucoma, steroid-induced glaucoma, posttraumatic and postoperative glaucoma, tumor-related glaucoma and glaucoma due to elevated episcleral venous pressure].
Greslechner R, Helbig H, Spiegel D
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2022; (119(5)):533-546 doi:10.1007/s00347-022-01630-6.
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7
Increased episcleral venous pressure in a mouse model of circumlimbal suture induced ocular hypertension.
Wong VHY, Zhao D, Bui BV, et al.
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8
Intraocular Pressure in the Eyes of Patients With Carotid-Cavernous Fistulas: Profile, Intereye Asymmetry, and Treatment Outcomes.
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9
Current management of glaucoma.
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The Medical journal of Australia 2019; (210(4)):180-187 doi:10.5694/mja2.50020.
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10
FP and EP2 prostanoid receptor agonist drugs and aqueous humor outflow devices for treating ocular hypertension and glaucoma.
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Experimental eye research 2023; (229()):109415 doi:10.1016/j.exer.2023.109415.
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11
Acute Closed-Angle Glaucoma-an Ophthalmological Emergency.
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12
Simplifying "target" intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma.
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PMID: 29582808

This page explains the historical term hypersecretion glaucoma and current approaches to high eye pressure for informational purposes only and does not constitute medical advice. Ask an ophthalmologist to interpret your findings and recommend care for your situation.

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Guide Contents