Normal tension glaucoma cases require unique treatment methods

ATLANTA —Preventing glaucomatous progression in normal tension glaucoma patients necessitates different treatment regimens than primary open-angle glaucoma, including earlier surgical treatment to minimize visual loss, a surgeon said here.

"The distinction between primary open-angle glaucoma and normal tension glaucoma is, you're more often required to use filtration surgery, a riskier procedure, to lower IOP," Kuldev Singh, MD, said at the Glaucoma Subspecialty Day preceding the American Academy of Ophthalmology meeting.

When approaching normal tension glaucoma cases, Dr. Singh said he more often follows untreated glaucoma suspects with low IOP than those with high pressure, especially when considering young Chinese patients. This helps prevent missing a possible progression.

Dr. Singh said there is also a need to examine nonglaucomatous causes in normal tension glaucoma patients, including examining structural and functional assessment of the optic nerve. He said those factors often play a more important role than IOP in determining glaucomatous progression in normal tension glaucoma cases.