Which statement best describes how target IOP should be managed?

• A. It is a fixed value determined at diagnosis
• B. It is only relevant after surgery
• C. It should always be as low as possible
• D. It is a range that may be adjusted based on risk factors and stability

Answer: (D)

The key idea is that target IOP is a flexible, personalized goal rather than a fixed number. In glaucoma care, you don’t pick one universal pressure at diagnosis and leave it; you establish a range of acceptable IOP values that aim to minimize damage while fitting the patient’s situation and treatment burden.

This target range is set by how much optic nerve damage there is, how quickly it’s progressing, and other risk factors such as age, vascular factors, family history, and corneal properties. If the eye remains stable on current therapy, you keep that range. If there’s progression or new risk factors, you tighten the target to a lower range. If treatment becomes too burdensome or causes issues, you might adjust the range within safe limits to maintain protection without overdoing therapy. Since IOP varies across the day and night, the target often reflects a range that accounts for those fluctuations and the possibility of higher readings at different times.

Choosing a target as low as possible isn’t always best, because driving IOP too low can pose risks like hypotony and reduced ocular perfusion. So the best answer describes a dynamic range that can be adjusted based on stability and risk—rather than a fixed value, or being applicable only after surgery, or always aiming for the lowest possible pressure.