Three-quarters of peak eye pressures fell outside clinic hours in home monitoring

The edition in brief

A modelling analysis of home rebound tonometry in 397 clinic patients, validated in 1,579 more, found that 6–7 days of monitoring with several readings a day captured 95% of the achievable accuracy for mean, peak, range and variability of intraocular pressure; primary open-angle glaucoma needed 9–10 days, and only three readings a day stretched that to about 10 days or more. Of peak pressures, 74% occurred outside usual clinic hours. A single-centre cohort of 462 people with HLA-B27-associated acute anterior uveitis found that adding oral prednisone to topical steroids was associated with faster complete control of inflammation (median 28 vs 41 days; adjusted HR 2.19), without longer total treatment, and courses beyond 14 days added nothing; selection bias favours the oral group being sicker. In 9,837 people from the Rotterdam Study, a deep-learning algorithm reading fundus photographs detected perimetric glaucoma with 70.6% sensitivity at 95% specificity and an AUC of 0.91, at about five referrals per true case; it had flagged over half of correctly identified cases years before diagnosis. The pearl is about red flags in a red eye.