Inaccurate Evaluation May Lead to Worsening Glaucoma

February 14, 2006

A study published in the February issue of Archives of Ophthalmology suggests that intraocular pressure (or eye pressure) is notably higher in patients with glaucoma when they are sleeping. This discrepancy between day and nighttime pressure becomes a problem when doctors are only conducting exams during the day to determine the severity and risk of the glaucoma worsening.

The study performed in Japan by Dr. Takeshi Hara of Jichi Medical School examined intraocular pressure in 148 patients with untreated glaucoma. Rather than just examining the patient's condition during the daytime hours, Hara and colleagues tested the participants 12 times throughout a 24-hour period, including every three hours throughout the night.

The doctor's found that while the average peak intraocular pressure level for patients who were seated was 16 mm Hg, the average peak pressure level for patients when lying down was as high as 18.9 mm Hg. A reproduced pressure was also calculated in the study, using the combined values of when the patient is sitting, and when the patient was lying while awake and lying while asleep. Of the patients, 29 percent had a reproduced pressure level of 21 mm Hg or greater when sleeping, compared to only three patients, or five percent, who displayed the same levels while sitting.

These results could indicate a serious shortcoming in the evaluation procedure of glaucoma patients. Patients who are inaccurately assessed could run the serious risk of a worsening condition.

The researchers concluded their study with the statement; "We are convinced that diurnal intraocular pressure changes should be reproduced with consideration for the posture of the patients."

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