Many people go for a physical examination and find high intraocular pressure, but usually do not feel that their vision is affected, and further examination by the doctor does not reveal any impairment of visual function. These patients, called hypertensive patients, have an eye pressure that is already above the normal range (21 mmHg) but the optic nerve and visual function are not yet impaired. These patients with hypertension are now faced with the confusion of treatment or no treatment: if they receive treatment, they may need to insist on drops of IOP-lowering medication, which will have a certain impact on their quality of life; if they do not receive treatment, once time has passed, some of the high IOP may cause glaucoma, and the damage to visual function caused by glaucoma is irreversible, which means that once glaucoma occurs, the damage suffered by the visual field will last forever. As a physician, I myself was torn between prescribing medication, because the patient would always rely on the medication to lower the IOP, and once the medication was stopped, the IOP would rise again or even rebound; and not prescribing medication, because the patient would be at risk of developing glaucoma. In the outpatient clinic, I usually communicate with the patient the pros and cons of the two options and let the patient choose. Generally, if the patient’s home is close to the hospital, the transportation is convenient, the IOP does not exceed 25 mmHg when it is high, and there is no family history of glaucoma in the family, the patient can consider not using medication, but should go to the hospital frequently for checkups, measure the IOP frequently, and do stereoscopic papillography when conditions allow, so as to avoid serious glaucoma lesions before treatment. The advantage of this is that the patient does not normally need to take drops, but the disadvantage is that he or she faces the risk of glaucoma damage. If the patient’s IOP is high above 25mmHg, the probability of glaucoma will be high and I recommend early intervention (lowering IOP) and not waiting unnecessarily. There are also patients whose IOP does not exceed 25 mmHg but who have poor access to medical care and are difficult to follow regularly, and if the patient agrees, anti-glaucoma medications can be prescribed. The advantage of these patients who receive treatment is that the patient is psychologically grounded after the IOP is lowered. The disadvantage is that they have to pay for eye drops, insist on daily drops, and their quality of life is affected. Recently I have been using a new technique, pneumatic trabeculoplasty (PNT), which can lower IOP by dilating the patient’s trabecular meshwork (the waterway of the eye) and superficial scleral veins. This can be done once to ensure that the IOP is within the normal range for 4-12 months, with individual variations. The advantage of this treatment is that it is basically non-invasive and does not harm the eye, but the magnitude of IOP reduction varies greatly from one patient to another, from nearly 20 mmHg to 3-4 mmHg, with an average of 6-10 mmHg. It is difficult for doctors to accurately assess the effect of IOP reduction before treatment, as is the case with many glaucoma treatments, including surgery. Patients who have a single PNT treatment can be assured that their IOP will be normal for a period of time and that they can live as normal for that period of time. At the same time, the IOP is constantly monitored, and if elevated IOP is detected, another treatment is done, or other treatment options are available. In general, there is no one-size-fits-all treatment for glaucoma or hypertension. Regardless of the treatment, patients need to monitor their IOP frequently and communicate with their doctors to make adjustments to their treatment if their IOP rises.