Glaucomatous Visual Field and Optic Nerve Progression at Low

Dr. Arthur Sit presents a case of a 71-year-old woman who was first diagnosed with glaucoma 11 years prior and had a significant family history of glaucoma. At the time of her diagnosis, her IOP was 21 mm Hg in the right eye and 20 mm Hg in the left eye. Despite apparently well-controlled IOP of 11–14 mm Hg, her visual fields have continued to decline in both eyes. The case highlights how reduction of IOP, even to low therapeutic levels, might be insufficient to stop glaucoma progression in all patients. Dr. Sit explores how IOP of any magnitude might contribute to glaucoma progression, factors beyond IOP that might contribute to the disease, and treatment options other than reduction of IOP.