Ocular hypertension
| Ocular hypertension | |
| ICD-10 | H40.0 |
|---|---|
| ICD-9 | 365.04 |
| DiseasesDB | 5226 |
| MeSH | D009798 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ocular hypertension (OHT) is intraocular pressure higher than normal in the absence of optic nerve damage or visual field loss.[1][2]
Current consensus in ophthalmology defines normal introcular pressure (IOP) as that between 10 mmHg and 21 mmHg. Elevated IOP is the most important risk factor for glaucoma, so those with ocular hypertension are frequently considered to have a greater chance of developing the condition.
Intraocular pressure can increase when a patient lies down. There is evidence that some glaucoma patients (e.g., normal tension glaucoma patients) with normal IOP while sitting or standing may have intraocular pressure that is elevated enough to cause problems when they are lying down.
Treatment
Medication
Ocular hypertension are mostly treated with pilocarpine, timolol, acetazolamide and clonidine[3]. There are also other, less commonly used, alternatives. Eye drops may initially be started either in one or in both eyes.[4]
| Medication | Mechanism | Dosage form[5] | Adverse effects[5] |
|---|---|---|---|
| pilocarpine | muscarinic agonist | eye drops | |
| timolol | β-receptor antagonist | ||
| acetazolamide | carbonic anhydrase inhibitor | systemic administration |
|
| clonidine | α2-receptor agonist | eye drops | |
| ecothiopate | cholinesterase inhibitor | eye drops | |
| carteolol | β-receptor antagonist | eye drops | |
| dorzolamide | carbonic anhydrase inhibitor | eye drops |
|
| apraclonidine | α-2 agonist | eye drops | |
| latanoprost | prostaglandin analogue |
Causes
Common Causes
- Acute angle-closure glaucoma
- Axenfeld-rieger syndrome
- Chandler iris naevus syndrome
- Congenital glaucoma
- Corneal arcus
- Essential iris atrophy
- Excessive aqueous production
- Glaucoma
- Hyphema
- Inadequate aqueous drainage
- Pigment dispersion syndrome
- Posner-schlossman syndrome
- Pseudoexfoliation syndrome
- Refractive ocular surgery
Causes by Organ System
Causes in Alphabetical Order
- Acute angle-closure glaucoma
- Alpha-l-iduronidase deficiency
- Amyloidosis
- Antipsychotic agents
- Atropine
- Axenfeld-rieger syndrome
- Chandler iris naevus syndrome
- Chlorpromazine
- Cocaine
- Congenital glaucoma
- Corneal arcus
- Cystathionine beta-synthase deficiency
- Essential iris atrophy
- Excessive aqueous production
- Fahr disease
- Glaucoma
- Glucocorticoids
- Hereditary onycho-osteodysplasia
- Hyphema
- Inadequate aqueous drainage
- Iridogoniodysgenesis type 1
- Levomepromazine
- Lowe syndrome
- Moore-federman syndrome
- Ocular trauma
- Perazine
- Phenelzine
- Pigment dispersion syndrome
- Pipothiazine
- Pizotifen
- Posner-schlossman syndrome
- Prednisolone
- Pseudoexfoliation syndrome
- Ranibizumab
- Refractive ocular surgery
- Steroids
- Sturge-weber syndrome
- Topiramate
- Tropicamide
- Weill-marchesani syndrome
References
- ↑ American Academy of Ophthalmology
- ↑ American Optometric Association
- ↑ Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-07145-4. Page 146
- ↑ [ http://www.biomedcentral.com/1471-2415/7/17 Interpretation of uniocular and binocular trials of glaucoma medications]
- ↑ 5.0 5.1 Unless else specified in boxes, then ref is: Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-07145-4. Page 146