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Ocular Hypertension

Elevated intraocular pressure without glaucomatous damage

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Ocular Hypertension?

Ocular hypertension (OHT) is defined as intraocular pressure greater than 21 mmHg measured on multiple occasions, in the absence of detectable glaucomatous optic neuropathy or visual field defects, and with open anterior chamber angles on gonioscopy. It is distinct from primary open-angle glaucoma (POAG), although it is one of the strongest predictors for its development.

The Ocular Hypertension Treatment Study (OHTS) demonstrated that approximately 9.5% of untreated OHT patients develop POAG over 5 years, and that IOP-lowering therapy reduces this risk by approximately 50%. Risk factors for conversion include older age, higher baseline IOP, thinner central corneal thickness (CCT), larger cup-to-disc ratio, and higher pattern standard deviation on visual field testing.

Management decisions are individualized based on calculated 5-year glaucoma risk using validated calculators (e.g., OHTS-EGPS Glaucoma Risk Calculator). Low-risk patients (<5%) are typically observed, moderate-risk (5-15%) considered for treatment, and high-risk (>15%) usually treated. First-line therapy includes prostaglandin analogs, with selective laser trabeculoplasty (SLT) as an alternative initial treatment per recent LiGHT trial evidence.

Symptoms

Asymptomatic in most cases
Detected on routine eye examination
Family history may prompt screening
Rarely: mild ocular discomfort
Halos around lights with very high pressure
No visual field defects (by definition)
Normal optic nerve appearance

Risk Factors

Age over 40 years
African or Hispanic ancestry
Family history of glaucoma
Thinner central corneal thickness
High myopia
Diabetes mellitus and hypertension
Long-term corticosteroid use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Routine eye examination after age 40
  • Family history of glaucoma
  • Diabetes or hypertension diagnosis
  • Long-term steroid therapy
  • Sudden increase in eye pressure
  • Eye pain with halos around lights (rule out angle closure)
  • Annual follow-up if previously diagnosed with OHT

Treatment Methods

01
Risk stratification with OHTS-EGPS calculator
02
Baseline visual field, OCT, and central corneal thickness measurement
03
Observation for low-risk patients with periodic monitoring
04
Topical prostaglandin analogs (latanoprost, travoprost, bimatoprost) for moderate-high risk
05
Beta-blockers, alpha agonists, or carbonic anhydrase inhibitors as alternatives
06
Selective laser trabeculoplasty (SLT) as first-line option
07
Ongoing surveillance with serial visual fields and OCT

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.