Clinical Glaucoma Research

In most forms of glaucoma, the intraocular pressure is higher than normal. The high pressure, along with other pathologic factors, damages the optic nerve, so that vision is lost over a period of time. In one type of glaucoma, called “normal tension glaucoma” (sometimes also called “low tension glaucoma”), the pressure is in the normal range, but the optic nerve suffers damage and vision is lost anyway. It is not known exactly why this happens, and for this reason it is also not known how much benefit is derived, if any at all, from lowering the intraocular pressure from a normal value of 17 mm Hg down to the range of 10-12 mm Hg, for example. Along with many other centers, we are randomly leaving some eyes with this condition alone while others are treated aggressively to achieve at least 30% lowering of pressure. Then, over the next several years, information is collected about whether or not the nerve suffers further damage and there is further slight visual loss, and at what rate any visual loss might be occurring, along with information about undesirable side-effects from the aggressive treatment. After several years we hope to know better how cases of this type should be treated.