In patients with a pathophysiologic condition of the optic nerve that makes it susceptible to glaucomatous damage it appears that the level of IOP affects the rate at which that damage occurs. Clinical trials published in the last three decades have confirmed that if IOP is lowered an eye with ocular hypertension is less likely to develop glaucoma, that established glaucoma with abnormal IOP is slowed or halted in its progression, and that eyes with normal tension glaucoma also suffer less progression of field loss [1, 5, 8]. The proportion of individuals with glaucomatous damage increases with increasing levels of IOP. Although the proportion of those with normal pressure who have glaucoma is small, individuals with normal pressure make up between one-third and one-half of all cases of glaucoma , perhaps simply because normal pressures are more common than abnormal pressure. Therefore, the level of IOP in itself is a poor means to detect glaucoma.
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