Glaucoma, the disease that never sleeps

Abstract

6Rev Bras Oftalmol. 2016; 75 (1): 5-6 Mansouri K Once such devices become available for routine clinical use, it will become obvious that we lack true understanding of the relationship between IOP and glaucoma:· Does nocturnal IOP have the same impact on glaucoma as diurnal IOP? · Which IOP parameters are most relevant to glaucoma: mean, peak, short or long-term variability? · Are there specific circadian IOP patterns that are related to glaucoma development and may predict its future progression?It is likely that the use of 24-h IOP monitoring will improve understanding and management of glaucoma. Ultimately, clinically-driven 24-h IOP data may lead to chrono-therapeutic delivery of glaucoma medications instead of the current practice of standard scheduling of drop instillation. In the meantime, clinicians are encouraged to obtain as many daily (and nightly) IOP measurements, possibly augmented with provocative testing, such as water loading, as possible to gain a better understanding of a patient's IOP dynamics and to personalize his treatment.