Risk factors of glaucoma progression: Intraocular pressure fluctuations

Intraocular pressure is not a fixed value and varies both over short-term periods and periods of several months or years. In healthy subjects, the circadian fluctuations in intraocular pressure are moderate, generally not exceeding 5 mmHg. In patients with glaucoma or ocular hypertension, intraocular pressure fluctuations are greater and circadian rhythms may be inverted. These fluctuations are probably involved in the conversion of ocular hypertension to glaucoma or glaucoma progression. Large observational clinical studies, however, are not unanimous on the role played by intraocular pressure fluctuations on the risk of conversion from ocular hypertension to glaucoma or glaucoma worsening. Nevertheless, it is important for each patient to estimate the short-term and long-term fluctuations and to prioritize a treatment that minimizes these fluctuations. (C) 2011 Elsevier Masson SAS. All rights reserved.