|Year : 1968 | Volume
| Issue : 3 | Page : 125-126
Intraocular tension in trendelenburg position
VN Prasad, B Narain, GS Katara
Department of Ophthalmology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, India
|Date of Web Publication||24-Dec-2007|
V N Prasad
Department of Ophthalmology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Prasad V N, Narain B, Katara G S. Intraocular tension in trendelenburg position. Indian J Ophthalmol 1968;16:125-6
|How to cite this URL:|
Prasad V N, Narain B, Katara G S. Intraocular tension in trendelenburg position. Indian J Ophthalmol [serial online] 1968 [cited 2020 Jul 6];16:125-6. Available from: http://www.ijo.in/text.asp?1968/16/3/125/37534
THIBERT  and B AILLIART AND LAVAT  first described the rise of intraocular tension in normal persons from the erect to the supine posture. Recently ARMALY and SALAMON,  GALIN,  and ROBERTS AND ROGERS  have confirmed the above view. The present study was carried out to learn the effect of posture on glaucomatous patients, which has also been studied by GARTNER AND BECK  and STROBL AND FOLLMAN. 
| Material and method|| |
This method has been carried out by the method described by GARTNER AND BECK,  with slight modification. The intraocular pressure (I.O.P.) is first measured by bending the head of the patient from the normal prone position [Figure - 1] bringing the head six inches above the level of the heels [Figure - 2]. The head is now brought level as in [Figure - 1] and the whole table inclined so that the head drops eight inches below the feet level in Trendelenburg position thus effecting a total drop of 14 inches [Figure - 3] of the head from position 2 in [Figure - 2]. The I.O.P. is now measured at intervals of one, two and three minutes.
| Observation|| |
Two groups of patients were observed, one group of normal persons of different age-groups to study the effect of the change in I.O.P. as control and the second group of glaucomatous patients.
| Discussion|| |
The table above is self-explanatory and shows how glaucomatous eyes respond markedly to this change in position. Changes in blood pressure and blood volume are the main factors which lead to change of intraocular tension. Ophthalmodynamometric studies have proved that there is a rise of arterial pressure, when the patient is made supine from the erect position. At the same time intraocular tension also rises. The rise in intraocular tension in such a headlow posture as the Trendelenburg position is probably due to rise in intraocular arterial and venous pressure and changes in blood volume due to retention of blood in the choroidal "sponge" in the eye. This is the basic idea of this test.
In normal persons this rise is compensated by some mechanism showing no appreciable rise of intraocular tension but in glaucomatous patients there is a definite rise of tension. This tension is maximum upto the second minute in the headlow Trendelenburg position. Even in poorly controlled cases of glaucoma, there is a rise in the tension.
| Summary|| |
Intraocular tension is increased when patient adopts a supine position from an erect posture and it is further increased in head-low position due to a defective compensation in the homeostatic-control of intraocular pressure in glaucomatous eyes. This test is used as a provocative test for cases of glaucoma, especially suspected glaucoma cases.
We are thankful to Dr. K. N. Mathur for his guidance in publishing this work.
| References|| |
ARMALY M. F., AND SALAMON S. S.: Schiotz and applanation tonometry: Arch. Oph. (Chicago) 70, 603, (1963).
BAILLIART, M. M. AND LAVAT: Comparative tonometric results in sitting and prone positions (In French). Bull. Soc. Ophthal. Paris, 36, 364, (1924).
GALIN, M. A., McIVOR, J. W. AND MAGRUDER, G. B.: Influence of position on intraocular pressure. Amer. J. Ophth. 55, 720, (1963).
GARTNER, S. AND BECK, W: Ocular tension in the Trendelenburg position. Amer J. Oph. 59, 1040, (1965).
ROBERTS, W. AND ROGERS, I. W.: Postural effects on pressure and ocular rigidity measurements. Amer. T. Ophth. 57, 111, (1964).
STROBL. C. AND FOLLMAN, P.: Intraocular pressure, body position and determination of rigidity; Ophthalmologica, 144, 57, (1962).
THIBERT, M.: Influence of decubitus on the intraocular tension of glaucomatous persons (In French). Bull. Soc. Belge, Ophthal. 45, 36, (1922).
[Figure - 1], [Figure - 2], [Figure - 3]
[Table - 1]