Ocular hypertension
Intraocular pressure above 21 mmHg without signs of glaucomatous optic neuropathy and without visual field changes. A risk factor for open-angle glaucoma.
ICD-10 H40.05 drugs
Also known as: OHT, Elevated intraocular pressure
Drugs used for this condition
- ABimatoprostFirst line · Topical prostamide / prostaglandin F2α analogue for ophthalmic useBimatoprost lowers IOP in ocular hypertension with elevated risk of glaucoma (thin cornea, family history, IOP above 26 mmHg). EGS 2024 and AAO PPP 2020 recommend prostaglandins as first line. Target IOP reduction is 20–30% from baseline with reassessment in 4–6 weeks.
- ABrimonidineSecond line · Topical selective α2-adrenergic agonist for ophthalmic useBrimonidine lowers IOP in ocular hypertension when prostaglandins are contraindicated (history of uveitis) or do not reach target reduction. EGS 2024 recommends brimonidine as second-line monotherapy or add-on to a prostaglandin.
- ATimololSecond line · Topical non-selective beta blocker for ophthalmic useTimolol lowers IOP in ocular hypertension. EGS 2024 and AAO PPP 2020 position it as second-line monotherapy when prostaglandins are contraindicated and as a component of fixed combinations.
- ATravoprostFirst line · Topical prostaglandin F2α analogue for ophthalmic useTravoprost is used to lower IOP in ocular hypertension with elevated risk of conversion to glaucoma (corneal thickness under 555 µm, IOP above 26 mmHg, age over 60, family history). EGS 2024 and AAO PPP 2020 recommend prostaglandins as first line in this group. The target is 20–30% IOP reduction from baseline.
- BDorzolamideSecond line · Topical carbonic anhydrase II inhibitor for ophthalmic useDorzolamide lowers IOP in ocular hypertension when prostaglandins and beta blockers are contraindicated or do not reach target reduction. EGS 2024 positions it as second-line monotherapy or add-on.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit