Page 15 - 21st Century Perspective - Glaucoma Supplement

can establish a more comprehensive IOP profile of these patients and provide them a higher level of
care. Consult www.icare-usa.com for more details.

Many glaucoma patients take oral antihypertensive drugs. It is important that such medications be

taken in the morning hours (or certainly by lunch), as it is well known that diastolic blood pressure
can become quite low during the sleep cycle; thus, taking an antihypertensive medicine at bedtime
may further suppress an already physiologically lowered nocturnal blood pressure. Having such
pathologically low diastolic pressure can diminish blood flow to the optic nerve, thereby potentiating
damage to the optic nerve and worsening the glaucoma. It would be beneficial to have a parallel
technology that allowed patients to monitor blood pressure at home during sleep cycles. It is
important to note that pathologically low diastolic blood pressure also sets the stage for stroke and
nonarteritic anterior ischemic neuropathy.

Glaucoma, in many ways, is an enigmatic disease. Whatever optometrists can do to bring further
insight and characterization of IOP behavior can enhance our ability to optimize patient care.

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