Ocular hypertension: Difference between revisions

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   MedlinePlus    = |
   MedlinePlus    = |
  eMedicineSubj  = oph |
  eMedicineTopic = 578 |
   MeshID        = D009798 |
   MeshID        = D009798 |
}}
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{{CMG}}
==Overview==
'''Ocular hypertension''' (OHT) is [[intraocular pressure]] higher than normal in the absence of [[optic nerve]] damage or [[visual field]] loss.<ref>[http://www.aao.org/aao/patients/eyemd/upload/Ocular-Hypertension-Glaucoma-and-Eye-Drops.pdf American Academy of Ophthalmology]</ref><ref>[http://www.aoa.org/x1799.xml American Optometric Association]</ref>
'''Ocular hypertension''' (OHT) is [[intraocular pressure]] higher than normal in the absence of [[optic nerve]] damage or [[visual field]] loss.<ref>[http://www.aao.org/aao/patients/eyemd/upload/Ocular-Hypertension-Glaucoma-and-Eye-Drops.pdf American Academy of Ophthalmology]</ref><ref>[http://www.aoa.org/x1799.xml American Optometric Association]</ref>


Current consensus in [[ophthalmology]] defines normal introcular pressure (IOP) as that between 10 mmHg and 21 mmHg.<ref>[http://www.webmd.com/hw/lab_tests/hw201323.asp webMD]</ref><ref>[http://www.emedicinehealth.com/articles/14545-1.asp eMedicine - Glaucoma Overview]</ref> 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.
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.
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==
==Treatment==
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|-
|-
|}
|}
==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===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Amyloidosis]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Antipsychotic agents]],  [[Atropine]],  [[Chlorpromazine]],  [[Cocaine]],  [[Glucocorticoids]],  [[Levomepromazine]],  [[Perazine]],  [[Phenelzine]],  [[Pipothiazine]],  [[Pizotifen]],  [[Prednisolone]],  [[Ranibizumab]],  [[Steroids]],  [[Topiramate]],  [[Tropicamide]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Alpha-l-iduronidase deficiency ]],  [[Axenfeld-rieger syndrome]],  [[Chandler iris naevus syndrome]],  [[Congenital glaucoma]],  [[Hereditary onycho-osteodysplasia]],  [[Iridogoniodysgenesis type 1]],  [[Lowe syndrome]],  [[Moore-federman syndrome]],  [[Sturge-weber syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Alpha-l-iduronidase deficiency ]],  [[Cystathionine beta-synthase deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Refractive ocular surgery]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Weill-marchesani syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Fahr disease]],  [[Glaucoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| [[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]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Antipsychotic agents]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Amyloidosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Ocular trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
===Causes in Alphabetical Order===
{{columns-list|
*[[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==
==References==
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==External links==
==External links==
*[http://www.emedicine.com/oph/topic578.htm eMedicine - Ocular Hypertension]
 
*[http://www.nei.nih.gov/glaucomaeyedrops/ National Eye Institute]
*[http://www.nei.nih.gov/glaucomaeyedrops/ National Eye Institute]
*[http://www.glaucoma-association.com/ International Glaucoma Association]
*[http://www.glaucoma-association.com/ International Glaucoma Association]

Latest revision as of 22:11, 10 January 2020

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]

Comparison table of ocular antihypertensives
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
  • bitter taste
  • burning sensation
apraclonidine α-2 agonist eye drops
latanoprost prostaglandin analogue

Causes

Common Causes

Causes by Organ System

Cardiovascular Amyloidosis
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Antipsychotic agents, Atropine, Chlorpromazine, Cocaine, Glucocorticoids, Levomepromazine, Perazine, Phenelzine, Pipothiazine, Pizotifen, Prednisolone, Ranibizumab, Steroids, Topiramate, Tropicamide
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Alpha-l-iduronidase deficiency , Axenfeld-rieger syndrome, Chandler iris naevus syndrome, Congenital glaucoma, Hereditary onycho-osteodysplasia, Iridogoniodysgenesis type 1, Lowe syndrome, Moore-federman syndrome, Sturge-weber syndrome
Hematologic Alpha-l-iduronidase deficiency , Cystathionine beta-synthase deficiency
Iatrogenic Refractive ocular surgery
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic Weill-marchesani syndrome
Neurologic Fahr disease, Glaucoma
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic 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
Overdose/Toxicity No underlying causes
Psychiatric Antipsychotic agents
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Amyloidosis
Sexual No underlying causes
Trauma Ocular trauma
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. ↑ American Academy of Ophthalmology
  2. ↑ American Optometric Association
  3. ↑ Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-07145-4. Page 146
  4. ↑ [ http://www.biomedcentral.com/1471-2415/7/17 Interpretation of uniocular and binocular trials of glaucoma medications]
  5. ↑ 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

External links

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