Many people who develop ocular hypertension did not develop vision loss over a 20-year study period — despite being at high risk of glaucoma, investigators have found. 

Ocular hypertension is a common condition that affects nearly 5% of people in their 50s, and up to nearly 8% of individuals aged 80 years or older. It also is a leading risk factor for the development of primary open-angle glaucoma, a blindness-threatening eye disease.

Investigators followed eye health outcomes in the Ocular Hypertension Treatment Study from 1994 to 2008 in 22 clinics. Some participants were randomly selected to be treated with eye medication for a period of the study. Data then were collected after 20 years of follow-up or within two years of death. 

The incidence of glaucoma rose steadily over 20 years, with 46% of participants overall developing the condition by the end of the study period. The percentage was higher — at 55% — among Black/African American participants. Only a fourth of participants developed visual field loss in one or both eyes, however, after adjustment for exposure time, reported lead author Mae O. Gordon, Ph.D., of Washington University School of Medicine in St. Louis.

“This study’s findings, together with a predictive model, may help clinicians and patients make informed personalized decisions about the management of ocular hypertension,” Gordon and colleagues concluded. 

Full findings were published in JAMA Ophthalmology.