Changes in pressure add to glaucoma blindness risk

The study team at Johns Hopkins University in Baltimore and two other academic medical centres found that large fluctuations during the day or over a number of days led to a greater risk of vision loss. Dr Ran Zeimer, director of the Ophthalmic Physics Laboratory at Johns Hopkins University's Wilmer Eye Institute, said the study showed that the daily variations in intraocular pressure must be controlled. They are also a good indicator for predicting risk after detecting glaucomatous damage is detected. Sixty-four glaucoma patients were taught to measure their own IOPs five times a day for five days before returning to their ophthalmologist for another recording. The pressures of the 105 eyes fluctuated by 4.3 mmHg on an average day and more than 10 mmHg over a five-day period. The results were then compared to the patients' medical records and vision tests over the next eight years. The study also found: - The measures taken at home over the five days were the strongest indicator of further vision loss (after accounting for baseline visual field loss). After eight years, 43 per cent of patients with low fluctuations remained stable, compared to only 12 per cent of those with high fluctuations in pressure - Moderate and severe visual field loss at the start of the study was strongly associated with progression, increasing the risk of further vision loss by three to eight times - White people had significantly less risk of vision loss than people of other races. By the end of two years, the risk of further vision loss was far higher for Afro-American people in comparison.