Normal Tension Glaucoma

Excerpt

Glaucoma is characteristic progressive optic neuropathy, featuring optic disc cupping and visual field loss, associated with raised intraocular pressure (IOP). Normal-tension glaucoma (NTG), also known as normal or low-pressure glaucoma, is defined as open-angle glaucoma with a presenting IOP in the normal range. The pathogenesis remains poorly understood, and there is controversy over whether it is a spectrum of primary open-angle glaucoma (POAG) or represents heterogeneous diseases.

The impact of NTG can range from non-progressive, asymptomatic disease to bilateral blindness. An impaired visual field leading to loss of a driving license can have a major impact on quality of life. Adverse effects and costs of medical and surgical treatments should be weighed against the risk of visual loss. NTG can masquerade as other optic neuropathies, and care should be taken to adequately investigate other causes when indicated.