High pressure, healthy nerve — what are the odds it becomes glaucoma? Five numbers from your exam answer it.
Implements the published OHTS-EGPS point system: age, untreated eye pressure, corneal thickness, cup-to-disc ratio and visual field PSD each score 0–4 points, and the sum maps to an estimated 5-year risk band — from ≤4% up to ≥33%. An educational implementation; not a diagnosis.
Before OHTS, high eye pressure meant guesswork: treat everyone, or wait for damage. The study followed thousands of people with ocular hypertension and found that five ordinary measurements predict who converts to glaucoma, and that pressure-lowering drops roughly halve the risk.
01
Age
Risk rises with each decade.
02
Eye pressure
Each mmHg of untreated pressure adds risk.
03
Corneal thickness
The headline finding: thin corneas convert far more often and under-read true pressure at the same time.
04
Cup-to-disc ratio
A larger vertical cup means less reserve in the nerve.
05
Field PSD
Subtle unevenness in the visual field, before glaucoma is diagnosable.
All five numbers come from a standard pressure work-up with our eye doctors in Los Angeles (pachymetry, OCT and fields included). Dr. Kevin Cohenmehr leads glaucoma and pressure monitoring.
A risk estimate from the Ocular Hypertension Treatment Study: five measurements — age, eye pressure, corneal thickness, cup-to-disc ratio and visual field PSD — each scored 0–4 points, with the sum mapping to an estimated 5-year chance that untreated ocular hypertension converts to glaucoma: 0–6 points ≤4%, 7–8 points 10%, 9–10 points 15%, 11–12 points 20%, over 12 points ≥33%.
A landmark NEI-sponsored trial in people with high eye pressure and healthy nerves. Untreated, about 9.5% developed glaucoma within five years; pressure-lowering drops cut that roughly in half. The study also identified which factors predict who converts.
Thin corneas were one of OHTS’s biggest findings: a thinner cornea both under-reads true pressure and independently predicts conversion. It is why a pachymetry measurement is part of every pressure work-up here.
Pattern standard deviation — a number printed on your visual field test that measures how uneven the field is. Quiet, healthy fields typically sit near 1.9 dB.
It implements the validated OHTS-EGPS point system published by the study investigators (Gordon et al., 2007) — the same scoring used by clinical references. The study group also maintains a continuous online calculator. Either way: use it to understand your numbers, then bring them to an exam.
There is no automatic threshold. Commonly, under about 5% leans toward monitoring and over about 15% toward discussing treatment, but family history, age, exam findings and your preferences all move the line. We have that conversation at the visit.
Told your pressure runs high? One work-up measures all five predictors (pressures, pachymetry, OCT and fields) and turns a worry into a monitoring plan with Dr. Kevin Cohenmehr.
