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Pearls from the EGS Guidelines
Pearls from the EGS Guidelines
Observation or Treatment? – Implications of the Ocular Hypertension Treatment Study

Publishing date: April 2021

Pearls Manager: Hari Jayaram

The OHTS was a multicentre randomised clinical trial designed to study the effect of topical ocular hypotensive medication in delaying or preventing the onset of glaucoma in OHT. Patients were randomised to medical treatment or no treatment. The goal of treatment was to lower IOP to < 24 mmHg and by at least 20% from baseline.

After 5 years, 4.4% of treated patients had develop glaucoma versus 9.5% of controls. More than 90% of untreated patients had not converted to glaucoma after 5 years.

EGS Guidelines, 5th Edition, Pages 37-38


1. Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 2002; 120:701-13.

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