What is the problem with determining target IOP by mmHg range?

• A. It doesn't consider the starting untreated IOP
• B. It's inconsistent with other methods
• C. It ignores age
• D. It ignores patient adherence

Answer: (A)

The main idea here is that a target IOP should reflect how much pressure needs to be lowered from a patient’s own baseline, not a one-size-fits-all number. Using a fixed mmHg range ignores the starting untreated IOP, which varies widely between individuals. Because the amount of reduction needed to protect the optic nerve depends on where you start, a universal range can lead to under-treating someone with a high baseline or over-treating someone with a lower baseline. In practice, targets are often defined as a percentage reduction from baseline or are individualized based on disease severity and optic nerve status, which captures how much pressure is truly needed to slow progression. While age and adherence matter for outcomes, they address different aspects of management rather than the fundamental pitfall of a fixed absolute range.