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Evidence to Improve Care

Diurnal Tension Curves for Assessing the Development or Progression of Glaucoma


Ontario Health Technology Advisory Committee Recommendation

There is insufficient evidence to support the adoption of diurnal tension curves in the management of glaucoma.

Read the full OHTAC Recommendation Report



Glaucoma is a leading cause of blindness, especially in older adults. The term covers a group of eye conditions that are usually caused by abnormally high pressure in the eye’s fluid. This problem, called intraocular pressure, damages the optic nerve, which is vital to good vision. The most common form of glaucoma has no warning signs, so it’s important to get regular eye exams that include a test for intraocular pressure. If glaucoma is recognized early, treatment can slow or prevent damage to the optic nerve.


Health Quality Ontario Reviews Diurnal Tension Curves for Assessing Glaucoma

For most people, intraocular pressure naturally changes during the day and overnight. It tends to peak at night because pressure rises when people lie down, and it’s usually higher in the morning than in the afternoon. Because of these fluctuations, a single test during normal office hours may not correctly detect a person’s risk of developing glaucoma or show how their disease is progressing. A test called a diurnal tension curve measures intraocular pressure every few hours over the course of a day.


Diurnal Tension Curves for Assessing the Development or Progression of Glaucoma: An Evidence-Based Analysis (PDF)
June 2011


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: Provider payment for the measurement of intra-ocular pressure is limited to once per day.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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