Raise target IOP when?

• A. In all patients
• B. Long term stable patients
• C. After acute angle closure
• D. New significant risk factors

Answer: (B)

Target IOP is adjusted based on how the disease has behaved over time. If a patient has been stable for a long period with little or no progression, you can raise the target IOP to reduce treatment burden and potential side effects, since the risk of progression is low and current protection is already adequate. The idea is to maintain safety while avoiding overtreatment.

Raising the target isn’t appropriate for everyone, because some patients may still be at risk of progression and need tighter control. After an acute angle-closure event, the priority is to lower IOP quickly to protect the optic nerve, not raise the target. When new significant risk factors emerge, you’d typically lower the target to reflect the increased risk and aim for tighter control.