TITLE:
Very High Intraocular Pressure and Associated Factors among Patients at Menelik II Hospital, Addis Ababa, Ethiopia: A Case-Control Study
AUTHORS:
Kibrom Mekonen Teferi, Abeba T. Giorgis, Alemayehu Woldeyes Tefera
KEYWORDS:
Glaucoma, Very high Intra Ocular Pressure, Pseudoexfoliative Glaucoma, POAG, ACG, JOAG
JOURNAL NAME:
Open Access Library Journal,
Vol.13 No.5,
May
28,
2026
ABSTRACT: Background: Intraocular pressure (IOP) normally ranges between 10 and 21 mmHg. Very high IOP (≥40 mmHg) represents a critical condition that, if not promptly managed, can result in irreversible blindness in short period of time. This study aims to assess the clinical profile and associated factors of very high IOP. Methods: A hospital-based case-control study was conducted from August 2022 to July 2023. Patients with very high IOP (≥40 mmHg) were compared to controls with high or normal IOP (Results: A total of 212 participants were included, comprising 82 cases with very high IOP and 130 controls. The mean IOP among cases was 46.6 mmHg (SD ±6), ranging from 40 to 65 mmHg, while the mean IOP in the control group was 18 mmHg (SD ±6.19). The most common glaucoma subtypes associated with very high IOP were primary open-angle glaucoma (28%), pseudoexfoliative glaucoma (24.3%), and juvenile open-angle glaucoma (17%). The distribution of glaucoma subtypes was generally similar between cases and controls, except that the third most common subtype in the control group was chronic angle-closure glaucoma rather than juvenile open-angle glaucoma. About half of the patients on follow-up were receiving anti-glaucoma medication at the time of evaluation. Severe visual impairment was observed in 62% of patients with very high IOP. No statistically significant association was found between very high IOP and the sociodemographic, clinical, or medical factors assessed. Conclusion: Very high IOP is strongly associated with severe visual impairment, emphasizing the need for early diagnosis and effective management. Sociodemographic, ocular, and medication-related factors are not associated with very high intraocular pressure.