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We read with great interest the article by Moodie et al1 questioning the importance of intraocular pressure (IOP) phasing outside office hours. IOP is the most important, treatable risk factor with regard to manifestation and progression of glaucoma. There is increasing evidence for the importance of IOP fluctuations in addition to its absolute level (overview in Sultan et al2).
In our opinion, the chosen study design cannot exclude a relevant bias as the subgroups were allocated by various physicians using non-standardised criteria. The sample size is comparatively small: 76 glaucoma patients of which a subgroup of only 41 patients was assigned for 24 h IOP phasing. Furthermore, the total number of glaucoma patients examined over the study period …