Ocular hypertension is defined as intraocular pressure (IOP) greater than 21 mmHg without evidence of optic nerve damage or visual field defects. It affects 4-10% of people over age 40. While the exact cause is unknown, genetic factors like myocilin gene mutations may play a role in increasing IOP. Those at highest risk include those with thinner corneas, older age, higher IOP, family history of glaucoma, and signs of nerve damage on exam. Treatment focuses on lowering IOP by at least 20% for high risk patients, while others are monitored regularly based on their level of risk.