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Ocular Hypertension and the Risk of Blindness

van Gestel, Aukje PhD*; Webers, Carroll A.B. MD, PhD*; Beckers, Henny J.M. MD, PhD*; Peeters, Andrea PhD; Severens, Johan L. PhD; Schouten, Jan S.A.G. MD, PhD*

doi: 10.1097/IJG.0b013e318287ac75
Original Studies

Purpose: To estimate the risk of blindness in patients with ocular hypertension (OHT) using an appropriate model and current empirical data.

Design: A Markov model with data from a systematic literature review.

Methods: A Markov model with 3 health states was built: OHT, primary open-angle glaucoma (POAG), and unilateral blindness. Literature was searched for reports on conversion from OHT to POAG and progression from POAG to blindness, to estimate a range of annual conversion and progression probabilities. The model had a cycle length of 1 year.

Results: The 15-year risk estimates ranged from 3.1% to 9.4% in untreated, and from 0.9% to 8.6% in treated patients with OHT. The ranges were the result of differences in patient populations, treatments, and outcome definitions in currently available empirical data.

Conclusions: The best estimates of the 15-year risk of unilateral blindness in patients with OHT, based on the currently available empirical data and an appropriate model, show that the risk is <10%.

*University Eye Clinic

Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht

Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands

Disclosure: The authors declare no conflict of interest.

Reprints: Jan S.A.G. Schouten, MD, PhD, University Eye Clinic, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands (e-mail:

Received June 18, 2012

Accepted January 2, 2013

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