Ocular hypertension is characterized by an intraocular pressure (IOP) exceeding 21 mm Hg, accompanied by a normal optic nerve and visual field ^[1]. It contrasts with normal-pressure glaucoma, where progressive glaucomatous optic neuropathy occurs despite normal IOP levels ^[2]. The clinical spectrum ranging from ocular hypertension to normal-pressure glaucoma has been attributed to various factors, including individual differences in susceptibility to IOP-related glaucoma, the impact of arterial blood pressure on the optic nerve head, vasospastic factors, and others ^[3]

Recent studies have highlighted a physiological relationship between IOP, arterial blood pressure, and cerebrospinal fluid pressure (CSFP) ^[4]. Individuals with higher IOP tend to have higher arterial blood pressure and CSFP, and vice versa. These findings, along with the optic nerve head's anatomy as a pressure barrier between the intraocular compartment (IOP) and the retrobulbar compartment (CSFP), have led to the hypothesis that individuals with ocular hypertension may have relatively high CSFP. Conversely, low CSFP might contribute to the development of normal-pressure glaucoma ^{[5 - 13]}.

In ocular hypertension, elevated CSFP may counteract increased IOP, maintaining the trans-lamina cribrosa pressure difference (TLCPD) within the normal range. To explore this hypothesis, a population-based study was conducted where CSFP was estimated using diastolic blood pressure, body mass index (BMI), and age ^{[14, 15]}. Previous research identified these parameters as significant determinants of CSFP in neurologically healthy individuals ^{[16 - 17]}. The present to now the prescription pattern of ocular hypotensive drug in ocular hypertensive patients

The study was conducted in the outpatient of department of ophthalmology at tertiary care hospital. The study was carried out a period after 3 weeks for a period of two years. Written informed consent form was taken from the patients. After taking inform consent, past and present history of the patients was taken.

Inclusion Criteria

1. Patients aged group between 10–40 years attending the OPD at tertiary care hospital.
2. Patients able to adhere to the follow-up schedule.
3. Patients ready to give inform consent
4. Patient having financial support for buying medicine.
5. Patients not on any ocular drugs.

Exclusion Criteria –

1. Patients less than 10 years of age.
2. Patient waring contact lens during the study period.
3. Patients having or had active ocular infections or pathological conditions.
4. Patients with any ocular disorders.
5. History of ocular surgery within the past 3 months.
6. Patient or patient attendant not ready to give inform consent form.
7. Patient taking ocular drug that is used for the study.

The clinical eye examination was done on all 152 patients among them 146 patients were included in the study 6 patients missed form the study. The demographical status, symptoms, bilateral and unilateral hypertension, prescription pattern of oral hypotensive drug and intraocular pressure were noted

Statistical Analysis:

The data collected form the OPD were noted and tabulated in MS Excel sheet and data was analyzed by using SPSS Software version 16. Unpaired t test or One-way Anova was conducted with all five classes of ocular hypotensive drug. p value less than 0.05 stated as statically significant and p value less than 0.005 stated as highly statically significant. 

Among 146 patients with ocular hypertension, the majority were male (65.75%) (Table 1) and predominantly aged 36–40 years (32.87%), followed by those aged 31–35 years (26.02%) (table 2)

A significant proportion, 116 patients (79.45%), presented with bilateral ocular hypertension (Table 3). Common symptoms included pain in 132 patients (90.41%), dryness in 124 (84.93%), redness in 98 (67.12%), impaired vision in 74 (50.68%), and headache in 26 (17.80%) (Table 5).

In terms of sociodemographic factors, most patients had myopia (114, 78.08%), along with coexisting high blood pressure (97, 66.43%) and diabetes mellitus (86, 58.90%) (table 4).

For the treatment with ocular hypotensive drugs resulted in a significant reduction in IOP after three weeks, with various drug classes showing effectiveness (p < 0.05) (Table 6).

Table 1 Gender decimation among ocular hypertensive patients.

Table 2 Distribution of age group among ocular hypertensive patients.

Table 3 Type of Ocular Hypertension observed in ocular defect patients.

Table 4: Sociodemographic status in patients with Ocular Hypertensive patients

Figure 01: Graphical representation in percentage number of patients having changes in sociodemographic status in ocular hypertensive patients.

Table 4 Symptoms observed in ocular hypertensive patents.

Figure 02 percentage difference in symptoms observed in ocular hypertensive patients.

Table 05 Number of patients developed glaucoma.

Table 06 prescription pattern of ocular hypotensive drugs in treatment of ocular hypertensive patients.

Figure 03 Prescription pattern of percentage use in ocular hypotensive patients.

Table 07: Changes in IOP Before and after treatment with different classes of oral hypotensive drugs.

Table 08 Mean difference between baseline and after treatment in patients with ocular hypotensive.

Figure 04 Graphical representation of mean average reduction in IOP After treatment with different ocular hypotensive drugs.

Ocular Hypertensive is a disease of eye causing rise in intraocular pressure causing effect on single eye or both eyes. As per the present research the majority of the patient were male 96 (65.75%) followed by female 50 (34.24%) respectively (table 01) with the age group of 36 to 40 years 48 (32.87%) followed by 31 to 35 38 (26.02%) respectively (Table 2). The patient having bilateral hypertensive among 116 (79.45%) followed by unilateral HT 30 (20.45%) respectively. The sociodemographic status majority of the patients having myopia 114 (78.08%), high blood pressure 97 (66.43%) and diabetes mellitus 86 (58.90%). The patient had symptoms of pain in eyes 132 (90.41%), dryness of eye 124 (84.93%), redness of eyes 98 (67.12%), improper vision 74 (50.68%) and headache 26 (17.80%) respectively. 28 (19.17%) developed glaucoma and 118 (80.82%) does not developed glaucoma. The ocular hypertensive patients were divided into five groups group A patients treated with prostaglandins, group B treated with beta blockers, group C patients were treated with antiadrenergic drugs, group D patients treated with carbonic anhydrase inhibitors and group E patients treated with miotic drugs Majority of the patients were treated with Ocular hypotensive eye drops like miotic drug in 36.98% followed by beta blockers in 41 (28.08%), carbonic anhydrase inhibitors 25 (17.12%), alpha adrenergic drug 18 (12.32%) and prostaglandins 08 (05.47%) respectively. The mean average IOP were measured in all five groups. after 1^st & 2^nd week of treatment there is no significant reduction in intraocular pressure but at 3^rd week of treatment there is a significant reduction in intraocular pressure in all five groups (p<0.05) respectively but the mean average improvement was seen in group E 10.73 ±0.90 followed by group c 10.02 ± 0.36 respectively.

According to Mae O. Gordon (1999) ^[18], the intraocular pressure among enrolled subjects was high enough to adequately assess the potential benefits of ocular hypotensive medications in preventing or delaying glaucomatous damage. The significant number of African American participants included in the study offers a reliable estimate of their response to topical medications.

David S. Friedman (2004) ^[19] noted that only a subset of patients with ocular hypertension eventually progresses to glaucoma. Determining whether to initiate therapy and the appropriate intensity of treatment can be challenging and requires a thorough understanding of the relative significance of risk factors for disease progression. This review evaluates the strength of evidence behind reported risk factors and provides insights that may aid in assessing individual patient risk for progression.

Ocular hypertension is an eye condition characterized by increased intraocular pressure (IOP). Research studies indicate that all classes of ocular hypotensive drugs effectively reduce IOP in patients with ocular hypertension. This drugs may also help to prevent the for other development of glaucoma.

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