What is the primary purpose of establishing a target IOP in glaucoma management?

• A. To maintain IOP within the normal range for all patients
• B. To significantly slow or halt disease progression while preserving visual function and quality of life
• C. To achieve the lowest possible IOP regardless of patient factors
• D. To eliminate all IOP fluctuations

Answer: (B)

In glaucoma care, the goal is to pick a target intraocular pressure that best reduces the risk of continued optic nerve damage and visual field loss while keeping treatment safe and tolerable. The primary purpose of establishing a target IOP is to slow or halt disease progression and preserve visual function and quality of life. This target is individualized based on how severe the disease is at diagnosis, how quickly it’s progressing, the patient’s baseline IOP, and how well they can tolerate treatments or surgeries.

Lowering IOP generally lowers the chance of further nerve damage, but there isn’t a universal “normal” IOP that works for everyone. Some patients experience progression even at normal-range IOPs (normal tension glaucoma), so the target is set to reduce risk rather than chase a single number. It’s also not about chasing the absolute lowest possible pressure in every case, since too aggressive lowering can cause side effects or intolerability, and completely eliminating fluctuations is not always feasible or necessary for every patient.