Background: Ocular Hypertension (OHT) poses a risk for developing Primary Open-Angle Glaucoma (POAG), which is a leading cause of irreversible blindness. Early detection of retinal ganglion cell (RGC) thinning may help identify OHT patients who require closer monitoring. Methods: This hospital-based, cross-sectional case-control observational study was conducted from February 2021 to January 2022. We included patients aged 40 years and older with Best Corrected Visual Acuity (BCVA) of 6/12 or better, diagnosed with OHT, and age-matched normal controls. Swept-source optical Coherence Tomography (SS-OCT) was used for macular ganglion cell layer (GCC) analysis, and visual field assessment was done using Humphrey Field Analyzer 10-2 and 24-2. Results: A significant thinning of the macular ganglion cell layer was observed in the inferior and inferonasal sectors in the OHT group (68.75±3.67 µm and 69.71±3.33 µm, respectively), compared to the normal group (69.88±4.34 µm and 71.83±2.64 µm, respectively). This thinning may be an indicator of early RGC loss in OHT patients. Conclusion: Macular ganglion cell layer thinning, particularly in the inferior and inferonasal sectors, may serve as an early marker for identifying OHT patients at higher risk of glaucoma progression, requiring more vigilant follow-up.