The effect of change in intraocular pressure on the natural history of glaucoma: lowering intraocular pressure in glaucoma can result in improvement of visual fields.

This paper reports a direct relationship between change in the level of intraocular pressure and the visual field of patients with glaucoma: improvement in the visual field with improvement of intraocular pressure and deterioration of visual field with deterioration of intraocular pressure. The documentation of change in visual field or optic disc (worse or better) is the most certain criterion of control. Unless improvement is noted to accompany lowering of intraocular pressure, adequacy of control cannot, with certainty, be assured. This concept is based on an analysis of 77 patients having trabeculectomy and 195 patients having argon laser trabeculoplasty without alteration of the optical system of the eye, in whom the visual field was determined with Octopus computerised perimetry before and after the pressure altering event.