Ocular Hypertension

Glaucoma is a major cause of blindness worldwide. To date, OHT remains the sole modifiable risk factor proven to reduce the incidence of OAG and prevent progression of glaucoma. Prior to diagnosis, a thorough examination must be performed to rule out secondary causes of elevated IOP. Additional risk factors must be considered to estimate each patient's probability of progression to glaucoma. The decision to initiate treatment should be based on the patient's risk profile, as well as his or her age, medical status, life expectancy, and preferences. Treating OHT reduces the risk of progressing to glaucoma by over 50% and should initially target a 20-25% decrease in IOP. Patients need to be followed for changes such as disc hemorrhages, which suggest an increased risk of progression. Both treated and untreated patients should be followed for structural and functional damage suggestive of glaucoma. If these changes are seen, treatment should be initiated or accelerated.