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AIM: To study the general diurnal IOP fluctuation in black adult patients with Primary Open Angle Glaucoma (POAG) attending Ruharo Eye Centre; to determine their IOP fluctuation range and determine their 24 hour IOP fluctuation pattern. DESIGN: This was a Hospital based, analytical cross section study. 51 black adult patients with POAG on different treatment options (No treatment, medical treatment and post trabeculectomy) were enrolled and their Intraocular Pressure (IOP) was measured every 2 hours for a period of 24 hours. SETTING: Located in rural south western Uganda, Ruharo Eye Centre is a tertiary specialist eye hospital. PARTICIPANTS: Black adult patients with Primary Open Angle Glaucoma attending Ruharo Eye Centre outpatient clinic. MAIN OUTCOME MEASURE: The mean fluctuation ranges, peak times and trough times of IOP were reported for each group and compared and their 24 hour fluctuation curve patterns were drawn. RESULTS: POAG patients who were not on treatment had the highest mean IOP fluctuation range of 11.11 (95% CI 8.29-13.94) mmHg. Patients on medical treatment had second highest mea fluctuation range of 9.29 (95% CI 7.50-11.06) mmHg respectively. Patients who had received trabeculectomy had the lowest mean IOP fluctuation ranges of 5.27 (95% CI 3.45-7.09) mmHg. The fluctuation ranges were statistically significant (P=0.005). The general average peak IOP time was between 11AM-1PM while the average trough IOP time was between 9PM-11PM. CONCLUSION: Trabeculectomy was found to have the best control of IOP fluctuation in patients with POAG compared to medical treatment and those not treatment. The best time for measuring IOP in patients with POAG was found to be between 11AM-1PM. This is because most of the Peak IOPs were recorded in this time.

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