Intraocular pressure decrease after local ocular cooling is underestimated by applanation tonometry.

Abstract

The effects of intense systemic or local cooling on aqueous humor dynamics in animals are an increased total outflow facility and a decreased aqueous flow. Few studies suggest that only vasoconstriction of arteriolar segments of the episcleral vasculature may be the cause for a decrease in intraocular pressure after local cooling in humans. Because corneal changes may have influenced such studies, the effect of local cooling was assessed in normal subjects. Intraocular pressure and corneal thickness were measured in 18 healthy human subjects before and after exposure of the right eye to both, an air stream at 20 degrees C, and an air stream at 0 degrees C. No significant changes in IOP or corneal thickness occurred under 20 degrees C conditions. After local cooling, the mean corneal thickness increased from 0.52 +/- 0.01 mm to 0.57 +/- 0.02 mm (p < 0.001). Mean intraocular pressure decreased from 13.8 +/- 2.9 mmHg to 12.9 +/- 3.1 mmHg (p < 0.026). The observed decrease in IOP correlated significantly but negatively (R = -0.53; p = 0.024) with the increase in corneal thickness, indicating that the cooling effect on IOP may be rather underestimated. The eye is very sensitive to local cooling effects, which may, however, partially be masked by changes in corneal thickness.