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    Ocular Hypertension Treatment Study (OHTS) Calculator

    Identifies patients that may benefit from therapy to lower intraocular pressure (IOP).
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    When to Use
    Pearls/Pitfalls
    Why Use

    Use in an outpatient setting in patients 30-80 years old with ocular hypertension to assess need for initial treatment to reduce the likelihood of progression to glaucoma.

    • The original studies used patients with a baseline intraocular pressure (IOP) of 22 to 32 mmHg.

    • Not validated in patients under 30 years of age or over 80 years of age.

    • Primarily developed from studies looking at the early development of primary open angle glaucoma (POAG) and has little utility in later stages of glaucoma.

    • Patients with potential secondary causes of elevated IOP including pigment dispersion or pseudoexfoliation should be excluded, as well as patients with non-glaucomatous reasons for visual field loss.

    • There are other established risk factors for the development of POAG, and these should be taken into account separately.

    Aids in shared decision making with patients regarding whether to initiate treatment for ocular hypertension based on the five-year risk of progression to open angle glaucoma.

    30-44
    0
    45-54
    +1
    55-64
    +2
    65-74
    +3
    ≥75
    +4
    <22
    0
    22 to <24
    +1
    24 to <26
    +2
    26 to <28
    +3
    ≥28
    +4
    >600
    0
    576–600
    +1
    551–575
    +2
    526–550
    +3
    ≤525
    +4
    <0.3
    0
    0.3 to <0.4
    +1
    0.4 to <0.5
    +2
    0.5 to <0.6
    +3
    ≥0.6
    +4
    <1.8
    0
    1.8 to <2.0
    +1
    2.0 to <2.4
    +2
    2.4 to <2.8
    +3
    ≥2.8
    +4

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    • Patients with a score between 0-6 can be observed every 6 months.

    • Patients with a score between 7-12 should be counseled about the risks and benefits of starting treatment versus close observation.

    • Patients with a score >12 should strongly consider initiating treatment.

    Management

    • Initiation of IOP lowering therapy.

    • Close monitoring with visual field and optic nerve head imaging every 3-12 months, depending on specific patient parameters.

    Content Contributors
    About the Creator
    Dr. Michael A. Kass
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