Corneacare Logo
  • CorneaCare Logo
  • Shop
    • Shop All
    • Eyelid Hygiene
    • Eye Vitamins
    • Eye Drops
    • Eyecare Bundles
  • Education
    • Dry Eye Disease
      • Dry Eye 101
      • Causes & Diagnosis
      • Lifestyle
      • Treatment
      • Why It Matters
    • Eye Health & Wellness
    • Eye Glossary
    • Take the Quiz
  • Community
  • App
  • Take the Quiz
  • Contact us
  • Login
  • My Account
Login
Cart Icon 0
Take the Quiz
  • Shop
  • Education
  • Our App
  • Take the Quiz
  • Shop
  • Education
  • Our App
  • Take the Quiz

A-Z Glossary

Table of Contents

Hypotony

Jovi Boparai MD Profile Picture
Written byJovi Boparai, MD
Jovi Boparai MD Profile Picture
Jovi Boparai, MDCo-founder & CEO of CorneaCarePhiladelphia, PA

Bio

Dry eye disease is tough! I get it. I have struggled with dry eyes for several years from contact lens use, and from spending countless hours looking at computer screens. In college, my dry eyes got so bad that I couldn’t wear contact lenses, because of a constant “foreign body sensation” when I had them in. I had to stop reading every 30 minutes because my eyes would start to burn and my vision would get blurry. I tried a plethora of treatments and nothing seemed to work. Dry eye disease was not only impacting my eyes, but also my emotional wellbeing. It was preventing me from enjoying life, and getting in the way of my professional training. I felt overwhelmed, frustrated and hopeless.

It was only when I realized that my dry eyes were linked to my lifestyle, environment and overall health did things start to make sense. I noticed that on days when I spent less time on the computer, my eyes felt better. My symptoms would flare when it was windy, or when there was low humidity. I knew that if I wanted to get ahead of my dry eyes, I needed to not only treat my eyes, but to also address my lifestyle. I started a consistent regimen of artificial tears and eyelid hygiene. I switched from monthly contact lenses to daily contact lenses. I started taking scheduled breaks from looking at a computer. I ate a healthier diet focused on anti-inflammatory/antioxidants foods, and I bought a humidifier for my room. In the beginning doing all this seemed impossible, but over time it became part of my usual routine. Not only did my eyes feel better, but I was overall healthier and happier! Turns out what is good for my eyes, was also good for my mind and body. I carried this lesson with me as I started my career to become an ophthalmologist and ophthalmic surgeon.

Because of my personal journey and professional training, I believe dry eye treatment starts by listening to and empowering the patient. I listen for the struggles and cue in on their strengths, while picking up on their lifestyle. Only then do we together start building a treatment plan that incorporates good eye hygiene with small, but impactful lifestyle changes. Our sight is our most important sense, and it is intimately linked to our very being. I want dry eye patients to not only get their dry eyes under control, but to also enjoy good mental and physical health, and live a fulfilling life. What is good for the eyes should also strengthen the mind and fortify the body!

Get to know me a little better!

Hobby: vintage watches
Food: peanut butter
Superhero: Superman
Guilty pleasure: desserts
Secret power: has never had a headache

Training:

Undergraduate: University of Pittsburgh Honors College
Medical school: Weill Cornell Medicine
Ophthalmology residency: Wills Eye Hospital.

  • Last updated December 13, 2022

What is Hypotony?

Hypotony is low pressure inside the eye that can lead to vision loss.¹ Most commonly, the condition results from eye surgery such as glaucoma surgery.² Trauma, like a blunt force to the eyeball socket with penetration of the eye, can also lead to hypotony.¹ 

Common symptoms include pain, vision loss and visual disturbance, but some people experience no symptoms at all. ³ Hypotony requires treatment, including medication and possibly surgery, to prevent further damage and vision loss.¹ 

Hypotony can last for weeks or longer (chronic hypotony) and if left untreated, can result in permanent structural damage to the eye with vision loss.³

Key Points

  • Hypotony is a serious eye condition resulting from eye surgery or trauma. 
  • Some people experience vision changes and pain, while others experience no symptoms at all.
  • Early detection is critical and patients should seek treatment immediately.
You brush your teeth,
moisturize your skin,
what about your eyes?
Take the quiz
Eyecare Quiz on Cellphone

Understanding Hypotony

Someone with hypotony has intraocular pressure (IOP) less than 6.5 mm Hg (millimeters of mercury).¹ Patients with IOP below 5 mm Hg often experience vision loss.¹ Normal IOP is between 12-21 mm Hg.¹  In hypotony maculopathy, the low IOP causes changes to the back of the eye, including choroidal folds in the retina and optic nerve edema, leading to vision changes.¹

Causes

Most cases of hypotony occur after eye surgery. An eye doctor will monitor pressure to ensure IOP starts to normalize. If pressure is still low after three months, it is considered chronic hypotony.⁵

Glaucoma filtering surgery is a common cause.¹ In trabeculectomy, the eye surgeon creates an incision in the scleral flap called a filtering “bleb” to increase fluid (aqueous humor) flow from the eye.¹ In some cases, the filtering bleb causes too much fluid to leave the eye.² In addition to an over-filtering bleb, trauma and eye infections or inflammation can lead to a bleb leak.² This increased outflow reduces the pressure in the eye, leading to hypotony.² 

In some cases, the ciliary body (space in the eye that produces fluid) doesn’t produce enough aqueous humor and the decreased aqueous humor leads to hypotony.³ This can happen after eye trauma, retinal detachment, eye inflammation or eye surgery, though it is rare.⁵

Treatment Options

An eye surgeon (ophthalmologist) should treat your condition immediately to prevent further damage and the onset of hypotony maculopathy. Treatment will depend on the cause. 

  • Non-surgical treatments include topical antibiotics and aqueous suppressants (to reduce aqueous outflow). For a bleb leak, a bandage contact lens can be used as a seal until natural healing and closure happens.1
  • Some cases will require autologous blood injections to promote scarring, surgical glue to seal the leak, or compression sutures to stop the fluid outflow.1
  • Surgical bleb revision is required when the above conservative measures fail.
  • When caused by penetrating eye trauma, scleral rupture, or retinal detachment, surgery is needed.

Chronic Hypotony

Should you develop chronic hypotony maculopathy, you may require retinal surgery. If not diagnosed early and treated promptly, permanent damage and vision loss may occur. This would be due to damage to the retina and optic nerve.

Bibliography

  1. Camras, Carl. “Hypotony.” Glaucoma Research Foundation, 2014, https://www.glaucoma.org/treatment/hypotony.php. Accessed May 2022.
  2. “Hypotony.” Department of Ophthalmology and Visual Sciences, 24 April 2017, https://webeye.ophth.uiowa.edu/eyeforum/cases/250-hypotony.htm. Accessed 3 May 2022.
  3. Aref, Ahmad A. “Hypotony Maculopathy – EyeWiki.” EyeWiki, 2 November 2021, https://eyewiki.aao.org/Hypotony_Maculopathy. Accessed 3 May 2022.
  4. “Intraocular Pressure – StatPearls.” NCBI, 31 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK532237/. Accessed 3 May 2022.
  5. Chung, Jae Keun. “Ocular Hypotony after Cataract Surgery in an Eye with Prior Trabeculectomy.” NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105787/. Accessed 3 May 2022.

Related Terms

Loading...

Episclera

is a fibroelastic structure consisting of two layers joined together loosely. It is the white of the eye

Dermatochalasis

describes the presence of loose and redundant eyelid skin. It is most often caused by aging

Chemosis

is the swelling of the conjunctiva, which is the clear membrane over the eyelids and the surface of the eye

Pupillometer

is a device that measures the distance between the pupils. The device is used when you order new eyeglasses

Spatial Frequency

describes the rate that a stimulus changes across space. It is usually measured with black and white line gratings

Macula Lutea

also known as the macula, refers to the small area in the back of the eye that is responsible for central vision

Related Articles

Loading...
  • Eye Health & Wellness

Before and After LASIK Eye Surgery: What to Know

9 min read

It’s important to understand the risks of LASIK surgery to have realistic expectations about your vision before and after LASIK eye surgery.
Heather Cottrell

Heather Cottrell

  • Eye Health & Wellness

White, Stringy Mucus in Eye

6 min read

What’s that white, stringy mucus in your eye? Find out what’s causing the discharge and what you can do about it.
Heather Cottrell

Heather Cottrell

  • Eye Health & Wellness

Grey Spot on White of Eye

6 min read

Grey spot on white of eye can be congenital or acquired, benign or malignant. An eye doctor can assess the spot and make a diagnosis.
Courtney Dryer, OD

Courtney Dryer, OD

Logo_Corneacare_White

    • Shop
    • Education
    • Community
    • App
    • Blog
    • Eye Glossary
    Menu
    • Shop
    • Education
    • Community
    • App
    • Blog
    • Eye Glossary
    • Contact
    • Terms of service
    • Privacy policy
    • Shipping & Returns
    • Contact
    • Terms of service
    • Privacy policy
    • Shipping & Returns
    • Education
    • Shop
    • Contact
    • Terms of service
    • Privacy policy
    • Shipping & Returns
    • Education
    • Shop
    • Contact
    • Terms of service
    • Privacy policy
    • Shipping & Returns
    • Education
    • Shop
    • Contact
    • Terms of service
    • Privacy policy
    • Shipping & Returns
    • Education
    • Shop
    • Contact
    • Terms of service
    • Privacy policy
    • Shipping & Returns
    Instagram Facebook_Pink Youtube Twitter Tiktok
    Copyright – © 2023 CorneaCare, Inc. ⚡️ All rights reserved
    *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease
    20% OFF personalized, convenient and effective eyecare.
    20% OFF personalized eyecare
    Take the quiz
    Take the quiz