For low-risk OHTN, what monitoring approach is recommended?

• A. Start medication immediately
• B. Laser therapy
• C. Monitor IOP, disc, OCT and VF
• D. Do nothing

Answer: (C)

In low-risk ocular hypertension, the aim is careful observation rather than immediate treatment. Not every elevated IOP progresses to glaucoma, so monitoring structure and function over time helps catch any early changes before they become irreversible. The best approach combines periodic intraocular pressure checks, close assessment of the optic nerve head for cupping or notching, and imaging and functional testing to detect early damage. OCT provides an objective measure of retinal nerve fiber layer thickness, while visual field testing reveals any developing functional loss. By regularly tracking IOP, the optic disc, OCT metrics, and visual fields, you can identify progression early and start treatment if needed. Starting medication or performing laser therapy would be more appropriate only if progression or higher-risk features appear, whereas doing nothing isn’t appropriate because ongoing monitoring is essential.