IOP Spikes and Fluctuation Patterns
In studies of IOP measured around the clock, we know that diurnal and nocturnal IOP rhythms fluctuate, with spikes often occurring outside office hours and often in the early waking hours. In addition to elevations of more than "normal" IOP, the CIGTS 9 year data has demonstrated that wide fluctuations even within "normal" IOP ranges have been associated and contribute to glaucoma progression. IOP is known to fluctuate over 24 hours and longitudinally, yet we rely on one IOP measurement every 3-4 months in the office for management decisions. So why are we not measuring IOP at various times of the day and night like other chronic diseases that demonstrate variability and fluctuation with better control leading to improved outcomes?
This talk will review the data we have now collected of 100s of cases of IOP fluctuations that are occurring in both surgically and medically "controlled" individuals as well as advocate for why treatment may need to be reconsidered especially in the face of VF loss and continued progression despite a "controlled" IOP in the office.