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Can reducing intraocular pressure help prevent vision loss due to glaucoma?

Dr. George A. Williams, MD
Ophthalmologist (Eye Specialist)

Elevated eye pressure is an important risk factor for the development of glaucoma, but glaucoma is diagnosed when damage to the optic nerve occurs. Your ophthalmologist will make a decision to treat the elevated pressure, or to monitor the pressure without treatment, based on the risk of developing damage. Normal eye pressure is defined statistically as 10 to 21 mm Hg. Glaucoma can develop at normal pressures, and patients with elevated pressure may never develop glaucoma. Other risk factors for glaucoma are also important, including race and family history. The most important thing is to make a commitment to the regular follow-up visits that your ophthalmologist recommends.

Dr. Gary S. Hirshfield, MD
Ophthalmologist (Eye Specialist)

Good question. Glaucoma is a disease of the nerve of the eye. The nerve is damaged in a characteristic way and that can lead to peripheral vision loss and ultimately central vision loss. Elevated pressure of the eye or intraocular pressure(IOP) is associated with glaucoma. That being said, many people who have elevated pressure do not develop glaucoma and many people with normal pressure do develop glaucoma. Other tests are needed to determine when eye pressure should be treated if at all. These tests should be performed and repeated in follow-up by an Eye M.D.

Dr. Laura C. Fine, MD
Ophthalmologist (Eye Specialist)

Several large trials have demonstrated the benefits of reducing intraocular pressure—whether through medications, surgery, or some combination to help prevent glaucoma (a group of eye diseases that cause vision loss through damage to the optic nerve). The Ocular Hypertension Treatment Study (OHTS), for example, involved more than 1,600 people recruited across the country who were at risk of developing glaucoma. OHTS investigators found that early treatment with eye drops to reduce intraocular pressure reduced by half the chance of developing damage to the optic nerve (nerve fibers that transmit visual impulses to the brain) or visual field loss due to glaucoma. Two other trials, the Advanced Glaucoma Intervention Study and the Collaborative Initial Glaucoma Treatment Study, further confirmed the benefits of lowering intraocular pressure, whether through various types of surgery or through medication.

Treating glaucoma
In the treatment of glaucoma (a group of eye diseases that cause vision loss through damage to the optic nerve), techniques in development, known as non-penetrating procedures, attempt to lower eye pressure by increasing flow through Schlemm's canal rather than by creating a filtering bleb (an elevation of the conjunctiva, the transparent membrane lining the inner surface of the eyelids). Three surgeries now available are non-penetrating deep sclerectomy, viscocanalostomy, and canaloplasty. In general, these procedures may not reduce eye pressure quite as much as filtering surgery, the goal of which is the development of a filtering bleb, and which remains the most common type of procedure used.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.