AIM:To study the pathogenic factors of high intraocular pressure, evolution process and relation with open angle glaucoma, and drug therapy. METHODS:Totally 217 cases of patients with ocular hypertension had 10 years follow-up including intraocular pressure, optic disc, vision, RNFL and accompanied by systemic disease factors examined. RESULTS: In the follow-up intraocular pressure of 181 cases maintained the status or no significant change, intraocular pressure elevated in 27 cases, visual field defects occurred in 9 patients . CONCLUSION: High intraocular pressure,and open angle glaucoma are not the same disease, but high intraocular pressure with the adverse factors can make the transition to high intraocular pressure in primary open angle glaucoma. So it should be followed up and observed closely, when necessary, anti-glaucoma treatment should be actively carried out.