Terminology used ocular hypertension when the intraocular pressure is above 21 mmHg without glucomatose damage that can be detected. In the study population, the average ocular hypertension pressure was 16 mmHg, which provide two standard deviations of the normal range of ocular hypertension pressure is 11-21 mmHg. In the elderly, the average ocular hypertension pressure have a higher value, especially women, and a standard deviation higher than younger individuals. This means that the normal ocular hypertension pressure in older women have a range of up to 24 mmHg.
Although 4-7% of the population aged over 40 years had IOP> 21mmHg, only 1% of individuals with ocular hypertension that develops into glaucoma annually. The risk of damage increases with increased IOP. The relationship between the prevalence of primary open-angle glaucoma (POAG) with Intraocular Pressure (Kanski, Jack J. 2003):
Structural changes in the nerve fibers of the retina and optic disc optic nerve causing changes in visual function (pre-perimetric glaucoma). So it will take several years before the damage can be detected by conventional perimetry.
Most patients with hypertension require no treatment, only those with a high risk should be given medication to slow or prevent the development of POAG. The thing to remember is that the treatment will be ongoing throughout the life of the patient and is likely to cause significant side effects. Therapeutic decisions for each individual based on the following risk factors .
• Risk factors for high in first
- Damage to nerve fibers of the retina
- Changes parapilar
- IOP> 30 mmHg or more
- IOP 26 mm Hg or greater and central corneal thickening <555um
- Cup-disc ratio of 0.4 or more and a thickening of the cornea<588um.
• Risk factors for secondary phase
- TIU 24-29mmHg nerve fibers without defect the nerve
- CD ratio> 0.3 and central corneal thickening> 588umA
- Family history of POAG in first-line
- High myopia history or from your parent descent.