Indian Journal of Ophthalmology

ARTICLE
Year
: 1968  |  Volume : 16  |  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

Correspondence Address:
V N Prasad
Department of Ophthalmology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur
India




How to cite this article:
Prasad V N, Narain B, Katara G S. Intraocular tension in trendelenburg position.Indian J Ophthalmol 1968;16:125-126


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 2021 Jun 20 ];16:125-126
Available from: https://www.ijo.in/text.asp?1968/16/3/125/37534


Full Text

THIBERT [7] and B AILLIART AND LAVAT [2] first described the rise of intraocular tension in normal persons from the erect to the supine posture. Recently ARMALY and SALAMON, [1] GALIN, [3] and ROBERTS AND RO­GERS [5] 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 [4] and STROBL AND FOLLMAN. [6]

 MATERIAL AND METHOD



This method has been carried out by the method described by GART­NER AND BECK, [4] 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

1ARMALY M. F., AND SALAMON S. S.: Schiotz and applanation tono­metry: Arch. Oph. (Chicago) 70, 603, (1963).
2BAILLIART, M. M. AND LAVAT: Comparative tonometric results in sit­ting and prone positions (In French). Bull. Soc. Ophthal. Paris, 36, 364, (1924).
3GALIN, M. A., McIVOR, J. W. AND MAGRUDER, G. B.: Influence of po­sition on intraocular pressure. Amer. J. Ophth. 55, 720, (1963).
4GARTNER, S. AND BECK, W: Ocu­lar tension in the Trendelenburg posi­tion. Amer J. Oph. 59, 1040, (1965).
5ROBERTS, W. AND ROGERS, I. W.: Postural effects on pressure and ocu­lar rigidity measurements. Amer. T. Ophth. 57, 111, (1964).
6STROBL. C. AND FOLLMAN, P.: Intraocular pressure, body position and determination of rigidity; Oph­thalmologica, 144, 57, (1962).
7THIBERT, M.: Influence of decubi­tus on the intraocular tension of glau­comatous persons (In French). Bull. Soc. Belge, Ophthal. 45, 36, (1922).