|Year : 1981 | Volume
| Issue : 1 | Page : 1-3
The influence of posture on intraocular pressure
Fatima Vaz, AK Gupta
Department of Ophthalmology, Goa Medical College, Panaji, India
Guru Nanak Eye Centre, Irwin Hospital, New Delhi-110002
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Vaz F, Gupta A K. The influence of posture on intraocular pressure. Indian J Ophthalmol 1981;29:1-3
At present Schiotz and the applanation tonometers (Goldman principle) are the most commonly used tonometers. While Schiotz tonometry is performed in the supine position, applanation tonometry is done usually in the sitting position on a slit lamp using Goldman applanation tonometer. With hand-held applanation tonometer and pneumo-tonometer, it is possible to measure the intraocular pressure both in the sitting as well as in the supine position. It is desirable that normal intraocular pressure is defined with reference to the posture in which the intraocular pressure is recorded.
Several authors (Galin, Mc-Ivor, & Magruder, Roberts & Rogers, Hetland-Eriksen, Tarkkanen & Leikola and Krieglestein & Langham) have reported that, in normal subjects, the intraocular pressure in supine position is higher than that in the seated position. There are hardly any studies available from our country on this problem.
The present study has, therefore, been undertaken to study the effect of posture on normal intraocular pressure in Indian subjects.
| Materials and methods|| |
412 eyes from 206 cases were subjected to the clinical study. Patients included in this study were either completely normal or ametropic, cataractous, aphakic or with some retinal disease such as diabetic retinopathy, retinitis pigmentosa etc. Cases of glaucoma or ocular hypertension were not considered at this stage of the study. It was ensured that both the sexes and various age groups had proper representation in the study. The intraocular pressure was recorded with Perkins hand-held applanation tonometer, first in the lying position. The patient was then made to sit and after 2 minutes interval intraocular pressure was again recorded in the sitting position. All measurements were performed by the same examiner. No head cushion was used in the supine position.
| Observations|| |
The observations of the present study of applanation tonometry in sitting and supine position are summarized in [Table - 1],[Table - 2],[Table - 3],[Table - 4],[Table - 5].
| Discussion|| |
The principle parameter investigated in the present series was the difference in the intra ocular pressure when changing from recumbent to sitting position. In the recumbent position the mean applanation intraocular pressure recorded was 14.12 mm Hg (S.D. 2.12) and 14.06 mm Hg (S.D. 2.13) in males in right and left eyes respectively. In females, the intraocular pressure recordings were 14.11 mm. Hg (S.D. 1.94) and 14.15 mm Hg (S.D. 1.99) in right and left eyes respectively. The mean applanation intraocular pressure in sitting position was 12.10 in right and left eyes in males with S.D, of 2.59 and 2.54 respectively.
In females the recordings were 12.29 mm Hg (S.D. 1.93) and 12.35 (S.D. 1.91) in the right and left eyes respectively.
The mean difference of intraocular pressure between the sitting and recumbent position was 2.02 mm. Hg in males and 1.82 mm. Hg in females. This difference was found to be statistically significant.
Various workers,,,,,, also observed higher intraocular pressure in the recumbent position. Whitty, however, did not observe any significant change between the intraocular pressure in sitting and supine position. Some of the workers observed that rise in supine position is more in glaucomatous eyes. We observed that the rise in intraocular pressure in recumbent position tended to be higher with increase in age. However the observation could not be confirmed statistically because of the small number of cases in each group. Jain and Marmion, also observed greater rise of intraocular pressure in the recumbent position with the increase in age.
Various reasons have been given to explain the rise of intraocular pressure in recumbent position. Anderson and Grant11 opined that multiple factors, perhaps, are at play to induce postural changes in intraocular pressure e.g. rise in episcleral pressure and uveal vascular engorgement. Jain and Marmion, have emphasised on baroreceptor mechanism to explain these changes.
| Summary|| |
The influence of posture on intraocular pressure was studied in 412 non-glaucomatous eyes, using Perkins hand-held applanation tonometer. The mean intraocular pressure in the recumbent position was higher by 2.02 mm Hg in males and 1.82 mm Hg in females. The rise in intraocular pressure in the recumbent position tended to be higher with the increase in age.
| References|| |
Galin, M.A., Mc-Ivor J. and Magruder G.B., 1963, Amer. J. Ophthalmol. 55 : 720.
Roerts. W., and Rogers. J.W., 1969, Amer. J. Ophthalmol. 57: 111.
Hetland-Eriksen, J., 1966, Acta. Ophthalmol. 44: 515.
Hetland-Eriksen, J., 1966, Acta. Ophthalmol. 44 : 522.
Tarkkanen, A., and Leikola, J., 1967, Acta Ophthalmol. 45 : 569.
Krieglestein, G.K., and Langham, M.E., 1975, Ophthalmolcgica (Basel) 171 - 132.
Armaly, M.P., and Salamoun, S.G., 1963, A.M.A. Arch. Ophthalmol. 79: 603.
Jain, M.R. and Marmion, V.J., 1976, Brit. J. Ophthalmol. 60 : 687.
Jain, M.R. and Marmion, V.J. 1976, Brit. J. Ophthalmol. 60 : 127.
Whitty, H.P.B., 1969 Brit. J. Ophthalmol 53 664.
Anderson, D.R., and Grant, W.M., 1973, Invest. Ophthaimol. 12: 204.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]