Glaucoma
Ocular Hypertension
Also known as: ocular hypertension, OHT, elevated IOP, high eye pressure, raised IOP no glaucoma, glaucoma risk IOP
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Intraocular pressure above the statistically normal range (typically >21 mmHg) with open angles, normal optic disc, and normal visual field. No glaucomatous damage. Per RANZCO pathway: CCT is essential for risk stratification; thin corneas increase conversion risk. Monitor at defined intervals; refer if disc, VF, or RNFL changes emerge or if IOP exceeds referral threshold.
Recognition
Symptoms: what patients report
- Asymptomatic.
- No field loss — by definition, OHT has no structural or functional damage.
Signs: what the examination shows
- Elevated IOP — typically >21 mmHg; threshold varies with population and CCT.
- Open angles on gonioscopy.
- Normal optic disc — no glaucomatous cupping, rim intact.
- Normal visual field.
- Normal RNFL on OCT or photo — no defect.
What OptoGuide™ covers for ocular hypertension
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked New Zealand therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Ocular hypertension (OHT) — College of Optometrists CMG
- Glaucoma: Now and Beyond. Jayaram H, Kolko M, Friedman DS, Gazzard G. Lancet (London, England). 2023;402(10414):1788-1801.
- Glaucoma in Adults—Screening, Diagnosis, and Management: A Review. Stein JD, Khawaja AP, Weizer JS. JAMA. 2021;325(2):164-174.
- Dysthyroid Eye Disease Masquerading as Glaucoma. Currie ZI, Lewis S, Clearkin LG. Ophthalmic & Physiological Optics : The Journal of the British College of Ophthalmic Opticians (Optometrists). 1991;11(2):176-9.
- Optometry Australia — A Diagnostic Guide to Posterior Eye Disease, Chairside Reference Pack (Centre for Eye Health), Version 2.0, 2026: Secondary Glaucomas
- RANZCO Referral Pathway for Glaucoma Management (2019). Royal Australian and New Zealand College of Ophthalmologists.
- Board publishes revised guidelines on glaucoma diagnosis and management (media release, 8 December 2014). Optometry Board of Australia.
- The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Kass MA, Heuer DK, Higginbotham EJ, et al. Archives of Ophthalmology. 2002;120(6):701-713.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.