Intraocular Pressure Fluctuation – Assess in Clinical Practice

Abstract

Intraocular pressure (IOP) is the main risk factor for the development and progression of glaucoma. Treatment is based on IOP reduction and isolated tonometric readings are usually performed for clinical management of the disease. However, IOP is not a static parameter and varies considerably throughout the day. This variability, or fluctuation, has classically been considered a risk factor for glaucoma. Nevertheless, recent studies demonstrate that pressure peaks are the most relevant IOP parameter for the prediction of visual field progression. The lack of a standard definition of IOP fluctuation compromises its clinical assessment and may explain in part the contradictory results found in the literature. This review will analyse options for IOP fluctuation assessment, their limitations and the impact of this parameter on the management of glaucoma.