Ophthalmology Times Europe finds 24‑hour IOP variation

Published May 17, 2026 by The Daily Scout

- Ophthalmology Times Europe reported on March 23, 2016 that a literature review found 24-hour intraocular pressure patterns differ by glaucoma treatment type. - Anastasios G.P. Konstas and colleagues wrote that one office reading captures only 1 of 1,439 minutes in a day. (europe.ophthalmologytimes.com) - The review appeared in Advances in Therapy, where Konstas and co-authors called for more long-term evidence on 24-hour treatment efficacy. (pmc.ncbi.nlm.nih.gov)

Why it matters

Ophthalmology Times Europe reported on March 23, 2016 that a literature review in *Advances in Therapy* found glaucoma treatments produce different 24-hour intraocular pressure, or IOP, patterns that may not be visible in office-hour checks. The review was led by Anastasios G.P. Konstas of Aristotle University of Thessaloniki and assessed evidence on medical, laser and surgical therapies across the full day-night cycle. (europe.ophthalmologytimes.com) The authors said clinicians often rely on single daytime readings even though pressure peaks and fluctuations can occur outside clinic hours. They wrote that those patterns can differ depending on the therapy used. (pmc.ncbi.nlm.nih.gov) ### Why did the review focus on 24-hour pressure rather than clinic readings? The 2016 review said glaucoma management is commonly built around reaching a target IOP, but published studies often assume that one daytime reading is enough to judge control. Konstas and colleagues wrote that single measurements “often do not adequately reflect” either untreated pressure behavior or the quality of treated control across 24 hours. Ophthalmology Times Europe quoted the authors as saying doctors need to check pressures more often than once and, if possible, at night when patients are asleep. (europe.ophthalmologytimes.com) The report said most clinicians measure IOP during visits about every three months, leaving much of the daily cycle unobserved. ### What number best captures the concern? The authors said a single IOP measurement shows what is happening for only 1 out of 1,439 minutes in a day, a figure highlighted in the Ophthalmology Times Europe report. That number was used to illustrate how a patient can appear controlled during office hours while still having untreated peaks or wide fluctuations at other times. (pmc.ncbi.nlm.nih.gov) A 2019 review in *Journal of Ophthalmology* described 24-hour monitoring as a potentially useful adjunct to spot office measurements because it can show circadian rhythm, peak timing and fluctuation magnitude in different glaucoma subtypes and patients. (europe.ophthalmologytimes.com) That review also said some treated patients continue to deteriorate despite apparently low IOP in clinic. ### Which treatments were described as behaving differently over 24 hours? The *Advances in Therapy* review said it evaluated evidence on medical, laser and surgical therapy options rather than treating IOP lowering as a single uniform effect. (europe.ophthalmologytimes.com) The authors wrote that controlled trials over the previous decade had expanded understanding of the 24-hour efficacy of these options, but that the evidence base remained uneven. The review chapter on glaucoma medications said significant gaps remained in understanding the short-term and especially long-term 24-hour efficacy of many antiglaucoma drugs. (pmc.ncbi.nlm.nih.gov) The broader 2016 review said that limitation matters because treatment choice includes surgery, laser and medication, each with different pressure-control profiles over the day-night cycle. ### Why does this matter when glaucoma still progresses? The 2019 review said up to 50% of glaucoma patients had normal initial IOP and that some treated patients still developed progressive optic nerve damage despite low measured pressure. (pmc.ncbi.nlm.nih.gov) It said recent studies showed that some pressure peaks occur outside office hours, which can help explain progression in patients who seem controlled in clinic. The American Academy of Ophthalmology’s *EyeNet* said traditional tonometry gives only a snapshot and quoted Mayo Clinic’s Arthur J. Sit as saying it is difficult to obtain the “big picture” without more frequent measurement. (europepmc.org) The article said newer monitoring tools were developed to capture fluctuations that office visits miss. ### What did the authors say should happen next? Konstas and colleagues wrote in 2016 that more long-term evidence is needed to evaluate the 24-hour efficacy of glaucoma therapies and the impact of IOP characteristics on progression and visual prognosis. (pmc.ncbi.nlm.nih.gov) The review said its purpose was to examine the concept and value of diurnal and 24-hour monitoring and to assess available evidence across treatment types. Ophthalmology Times Europe identified the paper as part of a broader discussion about how clinicians interpret apparently controlled office pressures. The next step described in the review was not a new trial date or regulatory action, but further long-term study of 24-hour treatment performance by named investigators including Konstas, Luciano Quaranta, Banu Bozkurt, Andreas Katsanos, Julian Garcia-Feijoo, Luca Rossetti, Tarek Shaarawy, Norbert Pfeiffer and Stefano Miglior. (aao.org) (europe.ophthalmologytimes.com) (pmc.ncbi.nlm.nih.gov)

Key numbers

Ophthalmology Times Europe reported on March 23, 2016 that a literature review found 24-hour intraocular pressure patterns differ by glaucoma treatment type.
Konstas and colleagues wrote that one office reading captures only 1 of 1,439 minutes in a day.
(europe.ophthalmologytimes.com) The review appeared in Advances in Therapy, where Konstas and co-authors called for more long-term evidence on 24-hour treatment efficacy.
(pmc.ncbi.nlm.nih.gov) Why did the review focus on 24-hour pressure rather than clinic readings?

What happens next

Ophthalmology Times Europe reported on March 23, 2016 that a literature review in *Advances in Therapy* found glaucoma treatments produce different 24-hour intraocular pressure, or IOP, patterns that may not be visible in office-hour checks.
The 2016 review said glaucoma management is commonly built around reaching a target IOP, but published studies often assume that one daytime reading is enough to judge control.
What did the authors say should happen next?

Sources

Quick answers

What happened in Ophthalmology Times Europe finds 24‑hour IOP variation?

Ophthalmology Times Europe reported on March 23, 2016 that a literature review found 24-hour intraocular pressure patterns differ by glaucoma treatment type. Anastasios G.P. Konstas and colleagues wrote that one office reading captures only 1 of 1,439 minutes in a day. (europe.ophthalmologytimes.com) The review appeared in Advances in Therapy, where Konstas and co-authors called for more long-term evidence on 24-hour treatment efficacy. (pmc.ncbi.nlm.nih.gov)

Why does Ophthalmology Times Europe finds 24‑hour IOP variation matter?

Ophthalmology Times Europe reported on March 23, 2016 that a literature review in *Advances in Therapy* found glaucoma treatments produce different 24-hour intraocular pressure, or IOP, patterns that may not be visible in office-hour checks. The review was led by Anastasios G.P. Konstas of Aristotle University of Thessaloniki and assessed evidence on medical, laser and surgical therapies across the full day-night cycle. (europe.ophthalmologytimes.com) The authors said clinicians often rely on single daytime readings even though pressure peaks and fluctuations can occur outside clinic hours. They wrote that those patterns can differ depending on the therapy used. (pmc.ncbi.nlm.nih.gov) Why did the review focus on 24-hour pressure rather than clinic readings? The 2016 review said glaucoma management is commonly built around reaching a target IOP, but published studies often assume that one daytime reading is enough to judge control. Konstas and colleagues wrote that single measurements “often do not adequately reflect” either untreated pressure behavior or the quality of treated control across 24 hours. Ophthalmology Times Europe quoted the authors as saying doctors need to check pressures more often than once and, if possible, at night when patients are asleep. (europe.ophthalmologytimes.com) The report said most clinicians measure IOP during visits about every three months, leaving much of the daily cycle unobserved. What number best captures the concern? The authors said a single IOP measurement shows what is happening for only 1 out of 1,439 minutes in a day, a figure highlighted in the Ophthalmology Times Europe report. That number was used to illustrate how a patient can appear controlled during office hours while still having untreated peaks or wide fluctuations at other times. (pmc.ncbi.nlm.nih.gov) A 2019 review in *Journal of Ophthalmology* described 24-hour monitoring as a potentially useful adjunct to spot office measurements because it can show circadian rhythm, peak timing and fluctuation magnitude in different glaucoma subtypes and patients. (europe.ophthalmologytimes.com) That review also said some treated patients continue to deteriorate despite apparently low IOP in clinic. Which treatments were described as behaving differently over 24 hours? The *Advances in Therapy* review said it evaluated evidence on medical, laser and surgical therapy options rather than treating IOP lowering as a single uniform effect. (europe.ophthalmologytimes.com) The authors wrote that controlled trials over the previous decade had expanded understanding of the 24-hour efficacy of these options, but that the evidence base remained uneven. The review chapter on glaucoma medications said significant gaps remained in understanding the short-term and especially long-term 24-hour efficacy of many antiglaucoma drugs. (pmc.ncbi.nlm.nih.gov) The broader 2016 review said that limitation matters because treatment choice includes surgery, laser and medication, each with different pressure-control profiles over the day-night cycle. Why does this matter when glaucoma still progresses? The 2019 review said up to 50% of glaucoma patients had normal initial IOP and that some treated patients still developed progressive optic nerve damage despite low measured pressure. (pmc.ncbi.nlm.nih.gov) It said recent studies showed that some pressure peaks occur outside office hours, which can help explain progression in patients who seem controlled in clinic. The American Academy of Ophthalmology’s *EyeNet* said traditional tonometry gives only a snapshot and quoted Mayo Clinic’s Arthur J. Sit as saying it is difficult to obtain the “big picture” without more frequent measurement. (europepmc.org) The article said newer monitoring tools were developed to capture fluctuations that office visits miss. What did the authors say should happen next? Konstas and colleagues wrote in 2016 that more long-term evidence is needed to evaluate the 24-hour efficacy of glaucoma therapies and the impact of IOP characteristics on progression and visual prognosis. (pmc.ncbi.nlm.nih.gov) The review said its purpose was to examine the concept and value of diurnal and 24-hour monitoring and to assess available evidence across treatment types. Ophthalmology Times Europe identified the paper as part of a broader discussion about how clinicians interpret apparently controlled office pressures. The next step described in the review was not a new trial date or regulatory action, but further long-term study of 24-hour treatment performance by named investigators including Konstas, Luciano Quaranta, Banu Bozkurt, Andreas Katsanos, Julian Garcia-Feijoo, Luca Rossetti, Tarek Shaarawy, Norbert Pfeiffer and Stefano Miglior. (aao.org) (europe.ophthalmologytimes.com) (pmc.ncbi.nlm.nih.gov)