Is there a single IOP value appropriate for all patients?

• A. True
• B. False
• C. Depends on age
• D. Not necessarily

Answer: (A)

There isn’t a single intraocular pressure value that fits every patient. In POAG, the goal is to tailor a target IOP to the individual’s risk and disease characteristics. While high pressure is a risk factor for progression, each person's optic nerve has different susceptibility, and the amount of damage already present varies. Factors like baseline IOP, how fast the disease is progressing, optic nerve appearance, visual field loss, central corneal thickness, age, and even systemic blood pressure all influence what level of pressure is tolerable.

Because of this, clinicians aim for a personalized target rather than a universal number. In a patient with advanced disease or clear progression, the target is typically lower to provide a bigger margin of safety. In someone with early disease and stable findings, the target can be higher but still keeping progression in check. Normal-tension glaucoma also shows that damage can occur at pressures that are not elevated, reinforcing that individuality is essential.

So the idea to hold is that a single IOP value isn’t appropriate for all patients; the most appropriate approach is to establish an individualized target based on the specific risk profile and disease status.