I thank Dr Jonas for his comments on our article.
It is difficult for us to estimate whether increased cerebrospinal fluid pressure in the supine position is “good” or “bad.” I agree that it might be good based on the point that the cerebrospinal fluid pressure acts as counterpressure to the IOP. As Dr Jonas and colleagues1,2 have described, an increase in the transmural pressure leads to glaucomatous damage, and the lamina cribrosa is thinner in eyes with glaucoma.
Hara T. Trans–Lamina Cribrosa Pressure Difference—Reply. Arch Ophthalmol. 2007;125(3):431. doi:10.1001/archopht.125.3.431-b