Meeting an unmet need in glaucoma: continuous 24-h monitoring of intraocular pressure

Intraocular pressure (IOP) is a major risk factor for glaucoma and lowering IOP remains the mainstay of glaucoma treatment. Current glaucoma management usually relies on single IOP measurements during clinic hours despite the fact that the majority of glaucoma patients have their highest IOP levels outside clinic hours. The fact that these IOP peaks go largely undetected may explain why certain patients have progressive disease despite treatment. The search for devices to facilitate continuous 24-h IOP monitoring started over 50 years ago, but only recently have technological advances provided clinicians with a device for continuous IOP monitoring. We discuss the shortcomings of Goldmann Applanation Tonometry, the current gold standard for tonometry, and our experience with the SENSIMED Triggerfish (R), a telemetric contact lens sensor for 24-h IOP monitoring. It may be possible to integrate 24-h continuous IOP monitoring into clinical practice, and this has the potential to contribute to the reduction of glaucoma-related vision loss.