Int. Ophthal. 3,1: 31-35, 1980 Correlations between intraocular pressure, visual field and visual acuity, based on 11 years of observations of treated chronic glaucomas P. NIESEL & J. FLAMMER Bern, Switzerland Keywords: glaucoma, visual field, intraocular pressure, visual acuity correlations Abstract In a retrospective study of 114 patients under treatment for chronic glaucoma (81 without and 33 with visual field defect) over an 11-year period of observation, a highly significant correlation between intraocular pressure and progression of visual field defects could be demonstrated. This correlation could be shown for the visual field outer boundary in 81 eyes with ocular hypertension and for typical visual field defects in 33 eyes with chronic glaucoma. The relationship was, however, only significant when both the standard deviation of the annual intra- ocular pressure and the influence of cataract development upon visual acuity were considered. Quantitative analysis of the results of Goldmann perimetry was by planimetry and took into account only changes during the 11-year observation period. Introduction In chronic glaucoma, the question of the relationship between intraocular pressure and visual field loss has been primarily addressed from the standpoint of the prognostic value of eye pressures measured at the beginning of the observational period (2, 3, 7). All of these studies are characterized by a semi-quantita- tive statistical treatment only of intraocular pressures and a purely qualitative treatment of visual field results. The eye pressure during the observational period was taken as the mean of three measurements (6), or as the mean of a not further defined number of measurements (2). It is clear from these obser- vations that the probability of visual field defects increases with increasing intraocular pressure. On the other hand, while eye pressure is a highly sensitive prognostic criterion, its specificity must be regarded as low. We have statistically analysed the data from 1 1 years of eye pressure measurements, Goldmann perimeter visual field determinations on 114 patients under medication for chronic glaucoma. The inclusion of visual acuity analyses in this statistical analysis was based on another statistical analysis of the behaviour of visual field outer boundaries in the case of cataract development (5). In this work, visual acuity was used in a first approximation as a parameter for the devel- opment of a cataract. Materials and methods During the years 1964 to 1974 inclusive, 174 patients undergoing regular medical or surgical treatment were observed. Average age at commencement of treat- ment was 61.2 + 10 years. Of the total of 274 chronic glaucomatous eyes, 90% could be classified as ocular hypertension and 10% as glaucoma with typical glau- comatous visual field defects. Seventy-seven per cent had open angle glaucoma (including 5% capsular glau- coma), 11% a chronic angle closure glaucoma and 12% a secondary glaucoma. Statistically significant dif- ferences (5% level) between these forms of glaucoma could not be found for the measured parameters. International Ophthalmology 3, 03"1-035 (1980) 0165-5701/80/0031-0031 $ 01.00. 9 Dr. W. Junk by Publishers, The Hague. Printed in the Netherlands.