The Optometric Glaucoma Society Annual Meeting took place October 7, 2025 offering a wealth of updates for the glaucoma community.
Among the most compelling topics was in-home tonometry—a technology now reshaping how we understand and manage intraocular pressure (IOP) variation.
Research shows that IOP is often highest outside clinic hours, occurring nearly 70% of the time¹—a likely reason some patients continue to progress despite achieving their target pressure in the exam room. Additional studies and recent discussion in Glaucoma Today² emphasize that nocturnal IOP peaks and large diurnal fluctuations³ are common and clinically meaningful.
Until recently, this information was inaccessible. The iCare HOME tonometer⁴ now allows patients to collect reliable IOP readings at home, typically five times daily over a seven-day period, with data transmitted directly to their doctor.
Having this richer data set has changed my own clinical approach—particularly in recommending selective laser trabeculoplasty (SLT) as first-line therapy. Evidence from the LiGHT Trial⁵ shows SLT is as effective as medication for initial treatment and offers the added advantage of reducing IOP variability.⁶ Given that IOP fluctuation itself predicts progression⁷, identifying pressure instability through home tonometry strengthens the case for early laser intervention.
Clinical Insight:
When IOP is captured beyond the clinic, patterns emerge that can fundamentally alter management decisions. Home tonometry helps reveal those patterns—and SLT provides an elegant way to stabilize them.References (Use collapsible or hover-expand formatting if your CMS supports it.)
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Barkana Y et al. Br J Ophthalmol. 2014;98(1):40–43.
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Ramulu PY. Glaucoma Today. Fall 2025.
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Liu JH et al. Invest Ophthalmol Vis Sci. 2003;44(4):1586–1590.
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Dabasia PL et al. Br J Ophthalmol. 2016;100(6):779–783.
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Gazzard G et al. Lancet. 2019;393(10180):1505–1516.
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Song J et al. Ophthalmology. 2015;122(7):1338–1343.
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Nouri-Mahdavi K et al. Ophthalmology. 2004;111(9):1627–1635.