NTG, Low BP & Circulation Issues—When to Start Drops?

My father has normal-tension glaucoma (NTG) along with small vessel disease and venous insufficiency. His blood pressure is often on the lower side (around 102/71), and he experiences eye discomfort that comes and goes all the time.

Some doctors take a more conservative approach with NTG and prefer to monitor, while others recommend starting drops earlier to protect the optic nerve. Because of his overall health profile, it feels like a judgment call on when to start treatment. He also sees multiple specialists and sometimes gets differing opinions on his care.

In addition to NTG, he has a history of optic neuritis and optic nerve thinning, so we’re trying to understand how NTG treatment fits into the bigger picture.

For those managing NTG with circulation or BP concerns, how did you and your doctors decide when to start treatment? Have you faced challenges balancing NTG management with low BP or vascular conditions? Would appreciate any insights!