How do you decide between escalating treatment with additional IOP-lowering medications versus surgical options for patients with normal tension glaucoma and progressive visual field loss despite well-controlled IOP?

Consider the number of drops the patient needs to control their IOP. Are there any local side effects other than allergy—tearing, redness, dry eye, etc.? All of these can affect compliance and efficacy.

A patient using more than two bottles of eyedrops is most likely going to be poorly controlled ov...