Intraocular Pressure Fluctuation in Angle Closure Glaucoma

Angle closure glaucoma tends to have a higher magnitude and greater fluctuation of intraocular pressure (IOP), and thus leading to more blindness. Primary angle closure glaucoma (PACG) has higher IOP than other subtypes of angle closure and the normal subjects. The presence of PAS usually correlates with high IOP. The characteristic of diurnal IOP varies among the different subtypes of angle closure disease, greatest in PACG and smallest in primary angle closure suspect. However, the diurnal IOP fluctuation does not always characterize well in the different subtypes of angle closure disease. Cataract surgery, glaucoma laser procedure, and trabeculectomy in angle closure eyes potentially offer an advantage in flattening diurnal IOP curve. Some literatures suggest that greater 24-h diurnal IOP is associated with disease progression in this glaucoma entity, however, the available data are still limited and controversial. Nevertheless, diurnal IOP is worth exploring in PACG individuals who show glaucoma progression despite a favorable clinic visit IOP.