Ocular hypertension

Ocular hypertension
ICD-10	H40.0
ICD-9	365.04
DiseasesDB	5226
eMedicine	oph/578
MeSH	D009798

Ocular hypertension (OHT) is intraocular pressure higher than normal in the absence of optic nerve damage or visual field loss.

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. There are also other, less commonly used, alternatives. Eye drops may initially be started either in one or in both eyes.

Comparison table of ocular antihypertensives

Medication	Mechanism	Dosage form	Adverse effects
pilocarpine	muscarinic agonist	eye drops
timolol	β-receptor antagonist	bradycardia bronchoconstriction
acetazolamide	carbonic anhydrase inhibitor	systemic administration	diuresis loss of appetite tingling neutropenia
clonidine	α2-receptor agonist	eye drops
ecothiopate	cholinesterase inhibitor	eye drops	muscle spasm systemic effect
carteolol	β-receptor antagonist	eye drops	bradycardia bronchoconstriction
dorzolamide	carbonic anhydrase inhibitor	eye drops	bitter taste burning sensation
apraclonidine	α-2 agonist	eye drops
latanoprost	prostaglandin analogue		ocular pigmentation

External links

• eMedicine - Ocular Hypertension
• National Eye Institute
• International Glaucoma Association