Doctors can sometimes be puzzled that seemingly well-treated glaucoma patients progress quickly, while others are remarkably stable. DeMoraes and colleagues offer insight into this complex question in a recent study.
They found that continuous 24-hour IOP measurement via a contact lens sensor (CLS) can detect unique factors that may be associated with glaucoma progression. IOP (eye pressure) spikes that were higher or had very rapid peaks (or both) were most highly associated with previous visual field progression (side vision loss). The CLS not only showed a more complete picture of IOP, but may allow us to project future functional loss even with minimal visual field history.
These encouraging results suggest that the application of CLS technology to practice might help us manage patients more effectively. However, I have a few reservations.
First, this is a retrospective analysis, and these results need to be verified via the relative rigor of a prospective study. Second, this device poses financial, technical and possible health concerns. For example, the risks of overnight wear include microbial keratitis. Overall, CLS has the potential to be as revolutionary as pachymetry or OCT to clinical care of glaucoma patients, but further work needs to be completed before it enjoys widespread clinical use.
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