Applanation tonometry (in office
eye pressure test) is the eye pressure equivalent of predicting the weather by looking outside your window. It merely gives you a snapshot of a dynamic and potentially volatile situation. We know that IOP fluctuation throughout the day and the extent of that fluctuation is a risk factor for glaucoma progression. With the emergence of a contact lens sensor (CLS), 24-hour IOP measurement studies are beginning to confirm those risks and attempting to predict visual field progression. This study describes one such predictive technique that shows promise.
While remote IOP measurement was inevitably going to become mainstream, the current COVID-19 situation highlights how vital such an at-home system can be. Nothing is more frustrating than knowing some of my patients may be progressing but not being able to monitor and treat them as I would like to.
Aside from the obvious advantage of predicting visual field progression, a CLS might help correlate and confirm OCT, visual field and funduscopy. Going forward, we will likely depend more on remote monitoring as we establish a new normal. Such innovations can serve our patients and practices well, particularly if there is a second round of the current pandemic.
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