I would like to thank Dr Spaeth for his thoughtful and pertinent comments regarding our article. Dr Spaeth has pointed out that both normal-pressure glaucoma and high-pressure glaucoma are heterogeneous entities. We completely agree, which is why we have stated that dividing patients with glaucoma on the basis of a completely arbitrary level of intraocular pressure is probably no longer useful. We need to develop techniques to determine the underlying cause for optic nerve degeneration in each of our patients so that intraocular pressure reduction may be used for those patients who will most benefit from this intervention whereas other yet to be developed therapies may address other underlying causes of optic nerve damage.
Mikelberg FS. Report Does Not Show That There Is No Relationship Between Disc Appearance and Sensitivity to Intraocular Pressure. Arch Ophthalmol. 2000;118(10):1465-1466. doi: