Which statement describes target IOP best?

• A. Target IOP equals normal population IOP
• B. Target IOP balances disease control with quality of life
• C. Target IOP should always be as low as possible regardless of side effects
• D. Target IOP is only based on IOP measurements without considering risk

Answer: (B)

Target IOP is an individualized goal that aims to reduce the risk of glaucoma progression while fitting the patient's ability to tolerate and adhere to treatment. This means picking an IOP level that lowers damage to the optic nerve and preserves vision without imposing excessive side effects, burden, or treatment demands.

In practice, the target is not simply the average normal IOP or the lowest possible number. It starts from the baseline IOP and is influenced by how serious the disease is (how much optic nerve damage and visual field loss has already occurred), how quickly it’s progressing, the patient’s age and life expectancy, and how much treatment the patient can realistically handle—including eye drops, lasers, or surgeries and their side effects. Because of these factors, the target may be moderately low for a high-risk patient or higher for someone with milder disease or significant treatment burden.

If progression occurs or treatment becomes poorly tolerated, the target can be adjusted downward or upward accordingly, always aiming to prevent further damage while preserving quality of life. This nuanced approach is why the best description is that target IOP balances disease control with quality of life.