Abstract
Purpose :
To investigate the distribution of intraocular pressure (IOP) level among a primary eye care population in an academic eye care facility and to determine whether there was significant relationship to time of day and patient care session.
Methods :
As part of a separate investigation, ocular and general health information was collected during 2011-2016 on consecutive patients belonging to six attending faculty at an urban academic eye care facility in Chicago, Illinois, USA. Relevant data was collected from the current examination, from the existing health record, and from a questionnaire independently completed by subjects at the time of exam. Subjects were included if they were >18 years of age, provided consent, and if they had dilated retinal examination and IOP measured via Goldmann tonometry on the day of exam. Eyes were excluded from analysis with history of past intraocular surgery, uveitis, or significant ocular trauma. Multivariable regression analyses were conducted to explore the relationship between IOP and time of day, with search for factors that might interact with time of day variation.
Results :
Analysis included 2,532 subjects (64.2% female, 82.7% African-American) who reflected facility demographics. Univariate analysis of all subjects showed a mean IOP=15.2+/-3.8 mmHg (right eyes), which had a very slight downtrend as the day progressed over three clinical care sessions (AM=15.4 mmHg; PM1=15.2 mmHg; PM2=15.1 mmHg). Multivariate control for numerous variables, including but not limited to gender, race, refractive error, education level, blood pressure, body mass index, smoking status, oral b-blocker use, corticosteroid use, and time of year, showed remarkable stability of IOP during normal workday and early evening hours (P>0.40). Likewise, the analysis did not show patient subtypes whose IOP varied significantly with time of workday except for those taking glaucoma medications (n=126). With control for other variables, their IOP trended significantly upward (P<0.001) as the day progressed.
Conclusions :
In this primary eye care teaching facility, Goldmann IOP level remained remarkably stable on average regardless of the workday hour, and the only patient subgroup whose IOP was modified by time of day were those taking glaucoma medications.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.