The Influence of Translaminar Pressure Gradient and Intracranial Pressure in Glaucoma: A Review

David A. Price, Alon Harris, Brent Siesky, Sunu Mathew

Research output: Contribution to journalReview articlepeer-review


The current evidence associating intracranial pressure (ICP) with glaucoma, the translaminar pressure gradient hypothesis, and anatomic factors likely affecting the relationship between ICP and retrolaminar tissue pressure including the size of the optic canal and lamina cribrosa thickness are reviewed. In addition, the evidence of diurnal and positional variation on the translaminar pressure gradient, effects of glaucoma medications, evidence of ICP helping to maintain cerebrospinal fluid flow in the optic nerve to prevent glaucomatous damage, and the effect of intraocular pressure variation in glaucoma are also reviewed. We find that while low ICP is associated with glaucoma disease in most studies, evidence is mixed on how closely ICP matches retrolaminar tissue pressure, and it appears the relationship is affected by the size of the optic canal, thickness of the lamina cribrosa, and lymphatic outflow from the optic nerve. Future studies can likely strengthen associations by measuring and controlling for some of these factors.

Original languageEnglish (US)
Pages (from-to)141-146
Number of pages6
JournalJournal of Glaucoma
Issue number2
StatePublished - Feb 1 2020
Externally publishedYes


  • glaucoma
  • intracranial pressure
  • intraocular pressure
  • translaminar pressure gradient

ASJC Scopus subject areas

  • Ophthalmology

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