R R

Which Adults With Ocular Hypertension Are Most Likely to Develop Glaucoma?

Adults with ocular hypertension are more likely to develop primary open-angle glaucoma if they're older, have higher eye pressure or thinner corneas, or have certain findings on optic nerve and visual field tests. In a long-term study, the estimated chance of developing glaucoma over 20 years was 31.7% in the lowest risk group and 59.8% in the highest risk group. These estimates describe study groups whose treatment changed over time.

Link to This Resource Page

Provide a valuable resource to your clients or customers by linking to this resource page. Just place the following link on your website.

To display this...

Which Adults With Ocular Hypertension Are Most Likely to Develop Glaucoma?

Adults with ocular hypertension are more likely to develop primary open-angle glaucoma if they're older, have higher eye pressure or thinner corneas, or have certain findings on optic nerve and visual field tests. In a long-term study, the estimated chance of developing glaucoma over 20 years was 31.7% in the lowest risk group and 59.8% in the highest risk group. These estimates describe study groups whose treatment changed over time.

read more about ocular hypertension ...

Copy this HTML:

Copy HTML Copied!

Why Can Adults With the Same Eye Pressure Have Different Risks?

Adults with the same eye pressure can have different glaucoma risks when their age or other exam findings differ. A prediction model combines pressure and age with the thickness of the cornea, the clear front surface of the eye. It also looks at the size of the central hollow relative to the visible head of the optic nerve and at how unevenly the eye detects light across the area you can see. Together, these measurements help estimate risk.

Does a Higher Risk Score Mean Glaucoma Will Develop Soon?

A higher risk score means glaucoma is more likely to develop over a given period. It can't tell you when or whether you'll develop it. In the long-term study, the estimated chance of developing glaucoma by five years was 11.9% in the highest risk group and 1.3% in the lowest. The risk groups came from measurements taken at the start of the study. The five-year figures describe what happened across those groups during the study.

Who May Benefit Most From Starting Eye Drops Earlier?

Adults at higher risk may have more to gain from starting pressure-lowering drops earlier. Among participants in the highest-risk third of one trial, an estimated 28% of those assigned to start drops right away developed glaucoma, compared with 40% of those assigned to observation first. The study compared the groups after a median of 13 years, and the original observation group started treatment after a median of 7.5 years. The comparison reflects early versus delayed treatment.

Does Developing Glaucoma Always Mean Losing Part of Your Visual Field?

No. An eye exam can detect glaucoma-related changes to the optic nerve before a visual field test detects loss. Across the long-term study cohort, the estimated chance of developing glaucoma by 20 years was 45.6%, while the estimated chance of glaucoma-related visual field loss in either eye was 25.2%. The study counted confirmed optic nerve changes or visual field changes due to glaucoma when determining whether a participant had developed the disease.

Learn More About Ocular Hypertension and Glaucoma Risk

Is Ocular Hypertension the Same as Glaucoma?

No. Ocular hypertension means the pressure inside your eye is higher than normal, with no detectable glaucoma damage. With glaucoma, an eye exam can detect damage to the optic nerve or changes in the visual field caused by that damage.

Does a Family History of Glaucoma Matter?

Yes. An eye doctor may consider your family history when assessing your chance of future vision problems. Tell them if a close relative has glaucoma.

Is There an Alternative to Eye Drops?

Yes. For eligible adults with ocular hypertension, an eye doctor may offer selective laser trabeculoplasty, a laser procedure that lowers eye pressure. Whether it's suitable depends on the exam and the risk of future vision problems.

When to See Your Doctor

Arrange an eye exam if a pressure check shows a high reading and you haven't had it assessed. If you already have ocular hypertension, keep the recheck schedule your eye doctor sets. They can use repeat pressure measurements and, when needed, optic nerve and visual field tests to look for changes and decide whether to adjust your care.

References

Archives of Ophthalmology. Delaying Treatment of Ocular Hypertension: The Ocular Hypertension Treatment Study. https://pubmed.ncbi.nlm.nih.gov/20212196/. Published March 2010. Accessed November 10, 2026.

Archives of Ophthalmology. The Ocular Hypertension Treatment Study: A Randomized Trial Determines That Topical Ocular Hypotensive Medication Delays or Prevents the Onset of Primary Open-Angle Glaucoma. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/270953. Published June 2002. Accessed November 10, 2026.

JAMA Ophthalmology. Assessment of Cumulative Incidence and Severity of Primary Open-Angle Glaucoma Among Participants in the Ocular Hypertension Treatment Study After 20 Years of Follow-up. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2778627. Published April 15, 2021. Accessed November 10, 2026.

National Institute for Health and Care Excellence. Glaucoma: diagnosis and management. https://www.nice.org.uk/guidance/ng81/chapter/Recommendations. Published November 1, 2017. Updated January 26, 2022. Accessed November 10, 2026.

Ophthalmology. Validated Prediction Model for the Development of Primary Open-Angle Glaucoma in Individuals with Ocular Hypertension. https://pubmed.ncbi.nlm.nih.gov/17095090/. Published November 7, 2006. Accessed November 10, 2026.