What is Ocular Hypertension?

Ocular hypertension is a condition caused by a buildup of pressure within the eye, also known as raised eye pressure. The condition itself doesn’t always cause immediate symptoms or vision loss, but ocular hypertension can increase the risk of developing serious eye conditions, such as glaucoma, if left untreated.

In this article, Optegra’s leading eye health experts will take you through everything you need to know about ocular hypertension, from its causes and symptoms to diagnosis and treatment. Understanding ocular hypertension causes and how to manage the condition are essential for protecting your long-term vision.

What is Ocular Hypertension?

Ocular hypertension refers to a higher-than-normal intraocular pressure (IOP) inside the eye (typically above 21 mmHg). There isn’t any noticeable damage to the optic nerve or loss of vision, making it a condition that requires regular monitoring rather than one that is immediately dangerous.

Can Ocular Hypertension Lead to Glaucoma?

Ocular hypertension is one of the strongest predictors of glaucoma. Not everyone with raised eye pressure will develop glaucoma, but many people who do have glaucoma started with ocular hypertension.

The good news is that early detection through regular eye tests can catch (and treat) the condition before it progresses. By identifying elevated eye pressure early, treatment can help reduce the risk of nerve damage and preserve vision.

Proactive monitoring is key. If it’s been a while since your last eye check, take a look at the signs you may need an eye test.

Ocular Hypertension vs Glaucoma – What is the Difference?

It’s important to distinguish between these two related, but not identical, conditions:

• Ocular Hypertension is high eye pressure without optic nerve damage or vision loss.
• Glaucoma involves high pressure and damage to the optic nerve, which may eventually lead to visual impairment.

While ocular hypertension can be a precursor to glaucoma, many individuals with raised IOP never develop nerve damage. The key lies in ongoing assessment and early management.

Symptoms of Ocular Hypertension – What to Look Out For

One of the challenges with ocular hypertension is that it typically has no noticeable symptoms. Most people are unaware they have the condition until it’s detected during a routine eye test. This is why regular eye checks are vital.

However, there are some instances where the pressure becomes significantly high that people may experience:

• Eye pain or discomfort
• Blurry vision
• Headaches
• Halos around lights

How is Ocular Hypertension Diagnosed?

Several advanced tests help determine whether someone has ocular hypertension or if the condition has progressed to glaucoma. These include:

• Contact Tonometry – measures intraocular pressure
• Optic nerve imaging – scans the optic nerve for any signs of damage
• Visual field tests – assess peripheral vision, which is often affected early in glaucoma
• Pachymetry – measures corneal thickness, which can affect pressure readings

These tools work together to give a comprehensive picture of eye health and help specialists decide the best course of action.

Treatment Options for Ocular Hypertension

The primary aim of treatment for ocular hypertension is to reduce IOP and protect the optic nerve from potential damage. Common treatment options include:

• Not everyone with ocular hypertension needs treatment; doctors assess the risk of glaucoma development over 5–10 years to decide.
• For moderate to high risk, treatment aims to lower eye pressure by about 20–25% to reduce glaucoma risk.
• Common treatments include prescription eye drops such as prostaglandins, beta blockers, carbonic anhydrase inhibitors, and alpha agonists.
• Laser therapy, especially selective laser trabeculoplasty (SLT), is another option to improve fluid drainage and lower eye pressure.

Surgery is less common but may be considered if medications and laser treatments are insufficient. As every case is different, treatment is tailored to the individual’s risk profile and response to therapy.

When to See an Eye Specialist

Everyone should have their eyes checked regularly, at least every two years. However, we recommend more frequent visits if you are at higher risk of developing an eye condition based on either of the following:

• You are over 40 and have a family history of glaucoma
• Belong to a high-risk group, such as those of African-Caribbean descent or people with diabetes