Ocular Hypertension

IOP >21 in the presence of healthy optic disc and normal VF

Risk of conversion to POAG (based on Ocular Hypertension Treatment Study)

• 9.5% conversion over 5 years (untreated) reduced to 4.4% if treated
• Risk factors for conversion
  • Older age
  • Higher IOP
  • Larger C:D ratio
  • Greater PSD
  • Thinner CCT
    • <555 microns associated with 3-fold risk of conversion compared to >588

Consider treatment if the patient is at risk of visual impairment within their lifetime

• IOP >24
• IOP >21 and thin cornea
• OHT in only eye
• OHT and CRVO/AION in either eye
• OHT and positive family history of (especially severe) glaucoma
• OHT and optic disc drusen

The latest NICE guidelines advise a risk assessment for each patient based on:

• Age
• IOP
• CCT
• Family history