Intraocular pressure changes during Valsalva maneuver

Abstract

Background: Valsalva maneuver (VM) is the performance of forced expiration against a closed glottis. Activities such as straining during defecation, blowing a balloon, lifting heavy weights, or playing the wind instruments like saxophone entail the performance of the VM. Even though many parameters such as blood pressure and pulse rate are changed to certain extent during VM. Aims and Objectives: This study aims to know whether any intraocular pressure (IOP) changes take place by performing VM. IOP is the fluid pressure of the eye. Increased IOP leads to ischemia of retinal nerve fiber. Decreased IOP can lead to impairment of the ocular functions. Elevation of IOP is the major risk factor to develop glaucoma primary open-angle glaucoma (POAG). Materials and Methods: 52 intern students (28 males and 24 females) among 20 myopics and 32 emmetropes are selected for this study from GITAM Institute of Medical Sciences and Research. Complete systemic and ocular examination is conducted. IOP is recorded with the correction of central corneal thickness. All of them are trained for “Valsalva Maneuver” for 10 days during their stay in unit posting. VM is practiced for 2 min. The IOPs recorded before and after the VM procedure. Results: There is a rise in the IOP after VM in all the 52 internee students. The average raise in the IOP after VM for 2 min is about 2.81 mmHg. IOP raised more in females than males. There is an increase of IOP in emmetropes than myopes. Conclusion: VM raises the IOP in all the individuals. The POAG individuals should be cautioned during the weight lifting, conditions which may lead to increase the intra-abdominal pressure. These conditions cause the natural VM. All these maneuvers can cause fluctuations in the IOP, which are dangerous and may lead to the progression of POAG. VM can be used as screening procedure for glaucoma.