eMedicine Specialties > Ophthalmology > Intraocular Pressure

Ocular Hypertension: Multimedia

Author: Jerald A Bell, MD, Staff Physician, Department of Ophthalmology, Billings Clinic; Glaucoma Director, Leadership Council Member, Physician Advocate for Personal Service Excellence Committee
Coauthor(s): Judie F Charlton, MD, Director - Division of Glaucoma, Professor, Department of Ophthalmology, West Virginia University
Contributor Information and Disclosures

Updated: Nov 10, 2008

Multimedia

Diagram of intraocular pressure distribution, wit...
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Media file 1: Diagram of intraocular pressure distribution, with a visible skew to the right (somewhat exaggerated compared to the actual distribution). Note that, while uncommon, there can be field loss among individuals with pressures in the upper teens. Also, note how the average pressure among those with glaucoma is in the low 20s, even though most individuals with pressures in the low 20s do not have glaucoma. Used by permission from Survey of Ophthalmology.
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Diagram of intraocular pressure distribution, wit...

Diagram of intraocular pressure distribution, with a visible skew to the right (somewhat exaggerated compared to the actual distribution). Note that, while uncommon, there can be field loss among individuals with pressures in the upper teens. Also, note how the average pressure among those with glaucoma is in the low 20s, even though most individuals with pressures in the low 20s do not have glaucoma. Used by permission from Survey of Ophthalmology.

Flowchart for evaluation of a patient with suspec...
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Media file 2: Flowchart for evaluation of a patient with suspected glaucoma. Used by permission of the American Academy of Ophthalmology.
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Flowchart for evaluation of a patient with suspec...

Flowchart for evaluation of a patient with suspected glaucoma. Used by permission of the American Academy of Ophthalmology.

Diagram showing the relative proportion of people...
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Media file 3: Diagram showing the relative proportion of people in the general population who have elevated pressure (horizontally-shaded lines) and/or damage from glaucoma (vertically-shaded lines). Notice that most have elevated pressure but no sign of damage (ie, ocular hypertensives), but there are those with normal pressures who still have damage from glaucoma (ie, normal tension glaucoma). (Diagram used by permission of M. Bruce Shields.) OHT = horizontal lines only NTG = vertical lines only POAG and other glaucomas with both elevated intraocular pressure and damage = overlapping horizontal and vertical lines
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Diagram showing the relative proportion of people...

Diagram showing the relative proportion of people in the general population who have elevated pressure (horizontally-shaded lines) and/or damage from glaucoma (vertically-shaded lines). Notice that most have elevated pressure but no sign of damage (ie, ocular hypertensives), but there are those with normal pressures who still have damage from glaucoma (ie, normal tension glaucoma). (Diagram used by permission of M. Bruce Shields.) OHT = horizontal lines only NTG = vertical lines only POAG and other glaucomas with both elevated intraocular pressure and damage = overlapping horizontal and vertical lines

Humphrey visual field, right eye, showing patient...
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Media file 4: Humphrey visual field, right eye, showing patient with advanced glaucomatous field loss. Notice both the arcuate extension from the blind spot (Bjerrum scotoma), as well as the loss nasally (nasal step), which often occurs early in the disease process. Courtesy of M. Bruce Shields.
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Humphrey visual field, right eye, showing patient...

Humphrey visual field, right eye, showing patient with advanced glaucomatous field loss. Notice both the arcuate extension from the blind spot (Bjerrum scotoma), as well as the loss nasally (nasal step), which often occurs early in the disease process. Courtesy of M. Bruce Shields.

Illustration of progressive optic nerve damage. N...
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Media file 5: Illustration of progressive optic nerve damage. Notice the deepening (saucerization) along the neural rim, along with notching and increased excavation/sloping of the optic nerve and circumlinear vessel inferiorly. Courtesy of M. Bruce Shields.
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Illustration of progressive optic nerve damage. N...

Illustration of progressive optic nerve damage. Notice the deepening (saucerization) along the neural rim, along with notching and increased excavation/sloping of the optic nerve and circumlinear vessel inferiorly. Courtesy of M. Bruce Shields.

Example of progressive visual field loss over tim...
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Media file 6: Example of progressive visual field loss over time (from top to bottom) in a patient with glaucoma. Notice the early appearance of an inferior nasal step and arcuate loss, with progressive enlargement and increasing density of the scotomata over time. Humphrey visual field courtesy of M. Bruce Shields.
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Example of progressive visual field loss over tim...

Example of progressive visual field loss over time (from top to bottom) in a patient with glaucoma. Notice the early appearance of an inferior nasal step and arcuate loss, with progressive enlargement and increasing density of the scotomata over time. Humphrey visual field courtesy of M. Bruce Shields.

Example of optic nerve asymmetry in a patient wit...
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Media file 7: Example of optic nerve asymmetry in a patient with glaucomatous damage, left eye, showing optic nerve excavation inferiorly similar to Image 5. Used by permission of M. Bruce Shields.
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Example of optic nerve asymmetry in a patient wit...

Example of optic nerve asymmetry in a patient with glaucomatous damage, left eye, showing optic nerve excavation inferiorly similar to Image 5. Used by permission of M. Bruce Shields.

Glaucomatous optic nerve damage, with sloping and...
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Media file 8: Glaucomatous optic nerve damage, with sloping and nerve fiber layer rim hemorrhage at the 7-o'clock position. Hemorrhage is indicative of progressive damage, usually due to inadequate pressure control. Further notching and pallor corresponding to the area of hemorrhage usually is seen several weeks after resorption of the blood. Courtesy of M. Bruce Shields.
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Glaucomatous optic nerve damage, with sloping and...

Glaucomatous optic nerve damage, with sloping and nerve fiber layer rim hemorrhage at the 7-o'clock position. Hemorrhage is indicative of progressive damage, usually due to inadequate pressure control. Further notching and pallor corresponding to the area of hemorrhage usually is seen several weeks after resorption of the blood. Courtesy of M. Bruce Shields.

Advanced glaucomatous damage with increased cuppi...
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Media file 9: Advanced glaucomatous damage with increased cupping and substantial pallor of the optic nerve head. Courtesy of M. Bruce Shields.
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Advanced glaucomatous damage with increased cuppi...

Advanced glaucomatous damage with increased cupping and substantial pallor of the optic nerve head. Courtesy of M. Bruce Shields.

Correction values according to corneal thickness.
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Media file 10: Correction values according to corneal thickness.
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Correction values according to corneal thickness.

Correction values according to corneal thickness.

Ocular hypertension study (OHTS). Percentage of p...
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Media file 11: Ocular hypertension study (OHTS). Percentage of patients who developed glaucoma during this study, stratified by baseline intraocular pressure (IOP) and central corneal thickness (CCT).
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Ocular hypertension study (OHTS). Percentage of p...

Ocular hypertension study (OHTS). Percentage of patients who developed glaucoma during this study, stratified by baseline intraocular pressure (IOP) and central corneal thickness (CCT).

More on Ocular Hypertension

Overview: Ocular Hypertension
Differential Diagnoses & Workup: Ocular Hypertension
Treatment & Medication: Ocular Hypertension
Follow-up: Ocular Hypertension
Multimedia: Ocular Hypertension
References
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Further Reading

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Keywords

ocular hypertension, OHT, intraocular pressure, IOP, glaucoma, primary open angle glaucoma, primary open-angle glaucoma, POAG, Ocular Hypertension Treatment Study, OHTS, high pressure inside the eye, glaucoma suspect, increased IOP, elevated IOP, high IOP, increased intraocular pressure, elevated intraocular pressure, high intraocular pressure, high eye pressure, elevated eye pressure, increased eye pressure, optic nerve, optic nerve damage, visual field defect, vision loss, blindness

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Contributor Information and Disclosures

Author

Jerald A Bell, MD, Staff Physician, Department of Ophthalmology, Billings Clinic; Glaucoma Director, Leadership Council Member, Physician Advocate for Personal Service Excellence Committee
Jerald A Bell, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

Judie F Charlton, MD, Director - Division of Glaucoma, Professor, Department of Ophthalmology, West Virginia University
Judie F Charlton, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Bradford Shingleton, MD, Assistant Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary
Bradford Shingleton, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Martin B Wax, MD, Clinical Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Ophthalmology Research and Development, Head, Ophthalmology Discovery Research, Alcon Labs, Inc
Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Society for Neuroscience
Disclosure: Alcon Labs Salary Employment

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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