Spontaneous trends in ocular pressure in untreated ocular hypertension.

Sixty ocular hypertensive patients receiving no treatment with ocular pressures of 21 mm Hg or more were followed up for a median time of 42 months for changes in ocular pressure. Three significant patterns were observed--stability, downward trend, or an upward trend. The majority of patients showed relatively stable pressures over the course of time. Cyclic swings of pressure over one- or two-year periods were also observed. A group of 43 normal patients with ocular pressures less than 21 mm Hg showed no trends of pressure with time except for three who had a small increase. For some patients, ocular hypertension appears to be a specific entity that represents either stable pressures with time or an episode of increased pressure that eventually decreases. In patients whose pressures continue to increase, ocular hypertension may become true glaucoma. Evaluation of the course of ocular hypertension in relation to diagnosis and treatment is important, especially in terms of the efficacy of treatment.

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