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Single office measurement not sufficient to assure IOP control

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Patients with glaucoma whose IOP seems to be under control based on a single in-office measurement can show higher IOP readings under different circumstances, a study found. Diurnal IOP measurement or a water drinking test can reveal higher IOP levels in many patients, the study authors said.

Fernando Korn Malerbi and colleagues at the University of Sao Paulo School of Medicine in Brazil retrospectively analyzed the records of 65 eyes of 65 patients with primary open-angle glaucoma who underwent diurnal IOP measurements followed by a water drinking test. In the diurnal testing, IOP measurements were taken every 3 hours between 8 a.m. and 5 p.m. All subjects had IOPs of 15 mm Hg or less at 11 a.m. or 2 p.m.

With diurnal testing, IOPs of 17 mm Hg or higher were reported in 16 of the 65 eyes (25%), and nine (14%) had IOPs of at least 18 mm Hg. The water drinking test demonstrated IOP values of more than 17 mm Hg in 32 of 65 eyes (49%). Twenty-two eyes (34%) had values of at least 18 mm Hg, 14 eyes (22%) had IOP levels of at least 20 mm Hg with the water drinking test.

The study is published in the British Journal of Ophthalmology.