Normal tension glaucoma can be stable for many years on treatment, with IOP remaining basically unchanged but then may suddenly progress. It usually takes 2-3 visual field tests (typically 3) in a year to accurately detect true glaucoma field progression as there can be considerable variability. Your ophthalmologist would usually weigh up the potential for irreversible visual field loss and how that impacts on vision. Sometimes it is better to move forward rather than allow this loss to happen, just to prove a point. It is a judgement call made between the patient and the treating ophthalmologist.
In simplest terms, the right IOP for a patient is one where the glaucoma does not get worse. It is very difficult to achieve very low pressures which may be necessary to halt glaucoma progression with drops sometimes and that is when surgical options such as trabeculectomy, which has been around since 1968, are explored. Laser (SLT) is non invasive with very few risks. Typically it works with higher pressures (most modern SLT trials do not include patients with an IOP under 18 for that reason) though, as it is non-invasive and low risk, sometimes it is explored in patients with lower IOP especially if surgery is considered best avoided.
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