Ocular Hypertension or Glaucoma suspect
To cut it short in points, We have to consider and evaluate the following risk factors when dealing with Ocular Hypertension or glaucoma suspect
- CCT (Central corneal thickness)
- IOP (Intraocular Pressure)
- CDR (Cup/disc ratio)
- PSD (Pattern standard deviation)
- Presence of diabetes mellitus (DM) or not
If GRF (Glaucoma Risk Factors) value exceeds 15% you should start treatment with the least dose and frequency required to obtain satisfactory IOP reduction)
In other words:
Who to treat Isolated Ocular Hypertension? If Intraocular pressure is more then 27 mmhg. (IOP>27mmHg)
- Ocular Hypertension (OHT) and suspicious disc: if IOP >21 mmHg.
- Ocular Hypertension and thin cornea: if IOP >21 mmHg.
- Ocular Hypertension and only eye.
- Ocular Hypertension and Central Retinal Vein Occlusion (CRVO) or Anterior ischemic optic neuropathy (AION) in either eye.
- Ocular Hypertension and Family History of glaucoma (especially of blinding disease)
– One can roughly estimate for every 20 microns that the CCT is >550 microns, the IOP is under-read by 1 mmhg
– Interestingly, this calculation reclassifies many Normal tension glaucoma (NTG) patients as high-tension Primary open angle glaucoma (POAG) and ocular hypertension patients as normals.