Erroneous assumption of ocular hypertension in patients with elevated intraocular pressure

PURPOSE: To determine the proportion of erroneously assumed ocular hypertension (OHT) among referred patients of elevated intraocular pressure (IOP) seen in glaucoma clinic of a teaching hospital in Northern India. METHODS: Retrospective review of case records of referred, diagnosed patients of OHT or unspecified glaucoma seen between January 2019 and March 2020. Using an algorithmic clinical approach, including gonioscopy, Goldmann applanation tonometry (GAT), and pachymetry, underlying cause for elevated-IOP was amended and proportion of erroneously assumed OHT was calculated. RESULTS: Of 276 patients diagnosed either as OHT or unspecified glaucoma before being seen at our glaucoma clinic, 44 (16%) had IOP within normal range (10–21 mmHg) on GAT. In 97 (35%) cases elevated-IOP was associated with angle closure. The central corneal thickness (CCT) was >550 μm in 39 (14%) patients with elevated-IOP. The proportion of erroneously assumed OHT was 70% in this study. CONCLUSION: The elevated-IOP does not imply with OHT unless evident through comprehensive clinical examination and appropriate investigations.