terminology and guidelines for glaucoma ii - Kwaliteitskoepel

4.2.7 - OCULAR HYPERTENSION (OH)
Although in the past it has been used as a diagnosis, Ocular Hypertension should be used to indicate that the IOP is
consistently outside 2 standard deviations above the mean. Consider corneal thickness (see Introduction II and Ch.
1.1; FC II and IV).
A modest increase in IOP is not sufficient reason for treatment, but consider it in patients with repeated IOPs in the
high twenties, even without risk factors. For treatment modality see Ch. 4.2.3-a. (See also Ch. 2.2.3. and flow-charts)
Ch. Introduction II
-If left untreated
* up to 9.5% develop glaucoma over 5 year of follow-up
* the risk of developing glaucoma increases with increasing IOP
* prophylactic IOP-lowering therapy to be discussed with individual patients considering the presence of
risk factors
Follow-up at intervals of 12 months initially, to be increased if all parameters remain negative, with exami
nation of:
- Optic disc
- Visual field
- IOP
- ONH and RNFL photographs initially and every 2-3 years
Patients for the ocular hypertension treatment study (Ch. Introduction II) were selected excluding myopes, labile
diabetics, poor compliance. In most of Europe black Africans are a minority.
NOTE:
Assess each patient individually when deciding whether or not to treat.
Ch. 4 - 6 EGS