Much has been written about the role of intraocular pressure (IOP) in the pathogenesis and clinical management of glaucoma. Although it is well understood that IOP is only one component in the diagnosis of the disease, many now argue that, given the development of high-tech diagnostic equipment that can detect more subtle visual field changes or measure thinning of the retinal nerve fiber layer, the relative importance of IOP has diminished. However, imaging and visual field testing can only detect damage that has already occurred. Certainly from a patient's point of view, it would be preferable to know ahead of time so the damage can be prevented. Early diagnosis of glaucoma leads to early treatment, with the goal of retained visual function using less aggressive therapy. IOP measurement is a fundamental glaucoma-screening tool, and IOP is the only modifiable risk factor on which treatment is based. Several large prospective clinical studies in the last decade, such as Ocular Hypertension Treatment Study (OHTS), Early Manifest Glaucoma Trial (EMGT), and the Advanced Glaucoma Intervention Study (AGIS), have provided strong evidence justifying IOP reduction.
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