Skip to content
How It Works
Explore
Ask a Question Resources Pricing
Who It's For
Patients
Decode results, prep for appointments, weigh options.
Caregivers & advocates
Carry the research load for someone you love.
Providers & clinicians
Resources for patients in your practice.
Log In Ask a Question
PubMed This is a summary of 21 peer-reviewed journal articles Updated
Ophthalmology

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

At a Glance

Living with hypersecretion glaucoma requires a personalized plan with a glaucoma specialist, regular pressure and vision testing, consistent treatment, and attention to exercise and emotional well-being. Contact your team promptly for vision changes or other new symptoms.

Living with a glaucoma diagnosis—especially one with a complex or historical label like “hypersecretion”—means entering a long-term partnership with a specialized medical team. While the monitoring can feel constant, its purpose is to ensure that your treatment plan is working and that your vision remains stable for the rest of your life [1][2].

Building Your Care Team

Depending on the cause of your high pressure, your team may include several different specialists.

  • Glaucoma Specialist: This is an ophthalmologist with fellowship training in glaucoma. They manage your eye drops, lasers, and monitor your optic nerve health [3].
  • Neuro-Ophthalmologist: If your high pressure is suspected to be caused by a vascular issue, a neuro-ophthalmologist evaluates how your eyes, brain, and nerves work together, looking for subtle signs of bulging or nerve weakness [4][5].
  • Neuro-Interventionalist: If a serious vascular problem like a carotid-cavernous fistula is confirmed by advanced imaging, this specialist performs the procedure to treat the blood vessel [6][7].

The Monitoring Schedule

There is no “one size fits all” for how often you should be seen. Your schedule depends entirely on your disease stage, your overall risk, and whether your condition is stable [1].

  • Stable Disease: If your pressure is at its target and your scans are unchanged, you may see your doctor every 6 to 12 months for a pressure check and imaging (OCT and Visual Fields) [1][8].
  • High-Risk or Changing Disease: Newly diagnosed patients, those with a recent treatment change, or those showing signs of worsening may be seen every 1 to 3 months [2][9].
  • Confirming Progression: Because tests like visual fields can be affected by fatigue, doctors often repeat a surprising or borderline test to confirm a trend. However, a markedly high pressure or a convincing structural change may warrant prompt action after a single visit [10][11]. Never delay contacting your team if you experience vision changes while waiting for a follow-up.

Lifestyle and Pressure Management

Most ordinary physical activity is highly encouraged and beneficial for your overall cardiovascular health. However, if you have specific vascular or orbital disease (like elevated episcleral venous pressure), your doctor may want to individualize your exercise restrictions [12][13].

Activities that temporarily spike pressure—such as intense straining, breath-holding during heavy weightlifting, playing high-resistance wind instruments, wearing very tight neckties, or head-down yoga inversions (like headstands)—can cause short-term IOP fluctuations [14][15][16]. Some patients also discuss sleeping with their head slightly elevated with their doctor [12]. Note that the evidence linking these transient spikes to long-term glaucoma progression is limited, and lifestyle changes can never substitute for medical treatment.

Managing the Psychological Toll

It is completely normal to feel “scan anxiety” or distress before your appointments. Glaucoma is a lifelong journey, and the fear of vision loss is real [17].

  • Acknowledge the Stress: Studies show that higher levels of distress are linked to more difficulty staying consistent with eye drops [17][18]. Use your treatment and attend follow-up as prescribed.
  • Speak Up: If cost, manual dexterity, memory, side effects, or anxiety make using your drops difficult, tell your team immediately so the plan can be adapted. Do not feel guilty—your doctor has strategies to help [19][20].
  • Seek Support: If the anxiety feels overwhelming, ask your doctor to connect you with patient support groups where you can talk to others managing similar challenges [21].

Common questions in this guide

How often should I have follow-up visits for hypersecretion glaucoma?
The schedule is individualized. If eye pressure is at target and scans are stable, visits may be every 6 to 12 months; new, high-risk, or changing disease may require visits every 1 to 3 months. Your specialist may adjust the timing after treatment changes or unexpected results.
Why might my visual field test or OCT eye scan be repeated?
Fatigue can affect visual field results, so a borderline or unexpected change is often repeated to see whether it represents a true trend. A very high pressure or clear structural change may require action after one visit. Ask how each result fits with your prior tests.
Do I need to change my exercise routine if I have hypersecretion glaucoma?
Most ordinary physical activity is encouraged, but breath-holding during heavy lifting, intense straining, high-resistance wind instruments, tight neckwear, and head-down yoga positions can temporarily change eye pressure. Ask your doctor whether vascular or orbital disease affects your recommendations. These lifestyle changes do not replace prescribed glaucoma treatment.
When should I see a neuro-ophthalmologist or neuro-interventional specialist?
A neuro-ophthalmologist may help evaluate suspected problems involving the blood vessels, eyes, brain, or nerves. If imaging confirms a serious blood-vessel problem such as a carotid-cavernous fistula, a neuro-interventional specialist may perform a procedure to treat it. Your glaucoma specialist can help coordinate these referrals.
What should I do if I have trouble using my glaucoma eye drops?
Tell your care team if cost, side effects, memory, hand control, or anxiety makes your drops difficult to use. They may adjust the treatment plan or offer practical strategies, and support groups may help with the emotional burden. Do not feel guilty about raising these concerns.
Which symptoms should I report before my next glaucoma appointment?
Contact your eye-care team promptly if you notice vision changes or new symptoms such as eye redness or a whooshing sound. Do not wait for a routine follow-up when symptoms are concerning or worsening. Your specialist can tell you how urgently you should be evaluated.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Based on my current risk and previous test results, how often should we be doing OCT scans and visual fields?
  2. 2.If we see a change on one test, will we repeat it before deciding to change my treatment?
  3. 3.Do you recommend I see a neuro-ophthalmologist or a neuro-interventional specialist to look at the blood vessels behind my eye?
  4. 4.Are there specific modifications I should make to my exercise routine, like avoiding breath-holding or certain yoga poses?
  5. 5.If I am feeling anxious about my upcoming scans, are there resources or support groups you recommend for glaucoma patients?

Questions For You

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

References

References (21)
  1. 1

    Evaluation of the Retinal Nerve Fiber Layer Thickness, the Mean Deviation, and the Visual Field Index in Progressive Glaucoma.

    Banegas SA, Antón A, Morilla A, et al.

    Journal of glaucoma 2016; (25(3)):e229-35 doi:10.1097/IJG.0000000000000280.

    PMID: 26020689
  2. 2

    Can Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebo-controlled Clinical Trial.

    Rossetti L, Iester M, Tranchina L, et al.

    Journal of glaucoma 2020; (29(7)):513-520 doi:10.1097/IJG.0000000000001565.

    PMID: 32541370
  3. 3

    Primary open-angle glaucoma.

    Weinreb RN, Leung CK, Crowston JG, et al.

    Nature reviews. Disease primers 2016; (2()):16067 doi:10.1038/nrdp.2016.67.

    PMID: 27654570
  4. 4

    A "Mismatched" connection: a rare case of indirect or dural carotid-cavernous fistula: a case based review.

    Jain R, Jagdhane N, Deshmukh S, et al.

    Annals of medicine and surgery (2012) 2024; (86(12)):7368-7376 doi:10.1097/MS9.0000000000002669.

    PMID: 39649866
  5. 5

    A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula.

    Pellegrini F, Zappacosta A, Cirone D, et al.

    Cureus 2022; (14(4)):e24634 doi:10.7759/cureus.24634.

    PMID: 35664394
  6. 6

    Transvenous embolization of indirect carotid-cavernous fistula via puncture of the cubital vein and distal radial artery.

    Gegenava BB, Dzhindzhikhadze RS, Shumakov DV, et al.

    Radiology case reports 2020; (15(7)):1103-1109 doi:10.1016/j.radcr.2020.04.047.

    PMID: 32477440
  7. 7

    Surgical management of glaucoma secondary to indirect carotid-cavernous fistula: A case report.

    Lopes EMP, Ludovico IC, Mota CDMG, et al.

    International journal of surgery case reports 2024; (116()):109317 doi:10.1016/j.ijscr.2024.109317.

    PMID: 38354573
  8. 8

    Rates of Local Retinal Nerve Fiber Layer Thinning before and after Disc Hemorrhage in Glaucoma.

    Akagi T, Zangwill LM, Saunders LJ, et al.

    Ophthalmology 2017; (124(9)):1403-1411 doi:10.1016/j.ophtha.2017.03.059.

    PMID: 28499748
  9. 9

    Optic disc hemorrhage in glaucoma: pathophysiology and prognostic significance.

    Kim KE, Park KH

    Current opinion in ophthalmology 2017; (28(2)):105-112 doi:10.1097/ICU.0000000000000345.

    PMID: 27820751
  10. 10

    Ageing and glaucoma progression of the retinal nerve fibre layer using spectral-domain optical coherence tomography analysis.

    Öhnell HM, Heijl A, Bengtsson B

    Acta ophthalmologica 2021; (99(3)):260-268 doi:10.1111/aos.14553.

    PMID: 33945669
  11. 11

    Consensus on Outcome Measures for Glaucoma Effectiveness Trials: Results From a Delphi and Nominal Group Technique Approaches.

    Ismail R, Azuara-Blanco A, Ramsay CR

    Journal of glaucoma 2016; (25(6)):539-46 doi:10.1097/IJG.0000000000000301.

    PMID: 26091178
  12. 12

    Effect of Body Position on Epsicleral Venous Pressure in Healthy Subjects.

    Arora N, McLaren JW, Hodge DO, Sit AJ

    Investigative ophthalmology & visual science 2017; (58(12)):5151-5156 doi:10.1167/iovs.17-22154.

    PMID: 28986593
  13. 13

    [Glaucoma due to elevated episcleral venous pressure].

    Greslechner R, Oberacher-Velten I

    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2019; (116(5)):423-429 doi:10.1007/s00347-018-0828-4.

    PMID: 30506098
  14. 14

    Intraocular Pressure Rise in Subjects with and without Glaucoma during Four Common Yoga Positions.

    Jasien JV, Jonas JB, de Moraes CG, Ritch R

    PloS one 2015; (10(12)):e0144505 doi:10.1371/journal.pone.0144505.

    PMID: 26698309
  15. 15

    Exogenous influences on intraocular pressure.

    Kim YW, Park KH

    The British journal of ophthalmology 2019; (103(9)):1209-1216 doi:10.1136/bjophthalmol-2018-313381.

    PMID: 30910873
  16. 16

    The Effects of Acute Intracranial Pressure Changes on the Episcleral Venous Pressure, Retinal Vein Diameter and Intraocular Pressure in a Pig Model.

    Ghate D, Kedar S, Havens S, et al.

    Current eye research 2021; (46(4)):524-531 doi:10.1080/02713683.2020.1805769.

    PMID: 32806985
  17. 17

    Psychosocial Predictors of Glaucoma Medication Adherence Among the Support, Educate, Empower (SEE) Personalized Glaucoma Coaching Pilot Study Participants.

    Salman M, Andrews C, Heisler M, et al.

    American journal of ophthalmology 2020; (216()):207-218 doi:10.1016/j.ajo.2020.02.009.

    PMID: 32087145
  18. 18

    Factors Affecting Adherence to Topical Glaucoma Therapy: A Quantitative and Qualitative Pilot Study Analysis in Sydney, Australia.

    Spencer SKR, Shulruf B, McPherson ZE, et al.

    Ophthalmology. Glaucoma 2019; (2(2)):86-93 doi:10.1016/j.ogla.2019.01.006.

    PMID: 32672609
  19. 19

    Adherence to Therapy in Glaucoma Treatment-A Review.

    Zaharia AC, Dumitrescu OM, Radu M, Rogoz RE

    Journal of personalized medicine 2022; (12(4)) doi:10.3390/jpm12040514.

    PMID: 35455630
  20. 20

    Understanding Barriers to Glaucoma Treatment Adherence among Participants in South India.

    Killeen OJ, Pillai MR, Udayakumar B, et al.

    Ophthalmic epidemiology 2020; (27(3)):200-208 doi:10.1080/09286586.2019.1708121.

    PMID: 31952462
  21. 21

    Adherence to treatment in patients with open-angle glaucoma and its related factors.

    Movahedinejad T, Adib-Hajbaghery M

    Electronic physician 2016; (8(9)):2954-2961 doi:10.19082/2954.

    PMID: 27790350

This page is for informational purposes only and does not constitute medical advice about hypersecretion glaucoma. Ask your glaucoma specialist to individualize your monitoring schedule, exercise plan, and treatment.

Get notified when new evidence is published on hypersecretion glaucoma.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.