The Ocular Hypertension Treatment Study (OHTS) is a randomized controlled trial of 1636 patients with elevated IOP and relatively healthy eyes that do no have any vision impairing ocular comorbidities, such as glaucoma and AMD. Investigators found that when they used glaucoma drops to treat high pressures, not only did IOP decrease by 22.5% (compared to 4.0% in the untreated group), but the risk of progression to glaucoma decreased by more than half, from 9.5% to 4.4%!

While starting drops seem to carry some benefit, there are some drawbacks, too, such as ocular surface irritation and notable out of pocket expense.

To better help determine who is most at risk of progression, this study highlighted a few key risk factors: older age, higher IOP, thinner central corneal thickness, and larger cup-to-disc ratio (both vertical and horizonal!).

So maybe the decision to treat patients with ocular hypertension considers a patient’s risk factors coupled with the costs and benefits of starting drops.

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