Ocular Hypertension: To Treat or Not to Treat?

Chandler and Grant urge us to discard the diagnosis ocular hypertension and use in its stead early open-angle glaucoma for patients with high intraocular pressures, open angles, normal optic discs, and normal visual fields. They also advocate early treatment of these patients to prevent glaucomatous loss of vision. Should we label these patients early glaucoma? Many of them will never lose vision. In addition, the word glaucoma has connotations of prospective blindness that frighten the patient and hamper his ability to obtain employment or insurance. Ocular hypertension is a useful term that accurately describes the condition without implying an unduly dire prognosis. It does not, of course, imply a totally benign condition offering no risk to the patient's vision. Obviously, some patients with ocular hypertension will in the future develop glaucomatous optic nerve damage, and all must be carefully watched for this possibility. The important issue raised by the editorial,