Evolving global risk assessment of ocular hypertension to glaucoma.
OBJECTIVE
To discuss current knowledge of global risk assessment in ocular hypertension.


RESULTS
The ophthalmologist treating patients with ocular hypertension is frequently faced with the clinical dilemma of which patients to treat and how vigorous treatment should be. The goal of risk assessment for glaucoma is to identify patients at greatest risk for symptomatic vision loss. Risk factors can be identified by history such as age, race, and family history or can be clinically observed by examination such as elevated intraocular pressure, optic nerve head appearance, central corneal thickness, and visual field abnormalities. Risk assessment is a well accepted tool in other fields of medicine. Parallels can be drawn between the evolution of risk assessment for coronary artery disease and glaucoma. Validated risk calculators for ocular hypertension are currently available mostly derived from the Ocular Hypertension Treatment Study.


CONCLUSIONS
The aim of assessing global risk for conversion from ocular hypertension to glaucoma is to identify patients who are most likely to benefit from early treatment. Calculation of risk should be accompanied by thorough analysis of risks, benefits, and alternatives for the individual patient.
Fechtner
Robert D
RD
Institute of Ophthalmology and Visual Science, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey 07103, USA. Fechtner@umdnj.edu
Khouri
Albert S
AS
D000367:Age Factors; D018450:Disease Progression; D005901:Glaucoma / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007429:Intraocular Pressure; D009798:Ocular Hypertension / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology