Mm Hg In Left Eye Research Articles

Bilateral Idiopathic Neuroretinitis.

Neuroretinitis (NR) is a rare inflammatory condition characterized by sudden vision loss, optic disc edema and macular star appearance predominantly affecting individuals in their third and fourth decades of life. This paper describes the case of 33-year-old Caucasian man with no significant medical history complaining of decreased vision for about a week. The ophthalmological exam revealed best-corrected visual acuity (BCVA) for the right eye (RE) of 0.8 (decimal notation) and of 0.9 for the left eye (LE). Intraocular pressure (IOP) was 20 mmHg in RE and 18 mmHg in LE. Slit-lamp examination of both eyes (OU) showed no evidence of intraocular inflammation in the anterior chamber or vitreous cavity. Examination of the posterior pole of the right eye showed bilateral papilledema with an incomplete macular fan pattern. Despite extensive laboratory tests, including serologic and imaging investigations, a definitive etiology remained unclear. It is very important to differentiate NR from other optic nerve disorders, requiring careful clinical evaluation and observation of the evolution of symptoms.

Ocular hypertension in a child of acute lymphoblastic leukemia

Abstract To highlight the case of ocular hypertension in a 9-year-old male who came with fever and swelling in the left eye (LE) for 3 days. He was a known case of acute lymphoblastic leukemia (ALL) on treatment with oral steroids. His best-corrected vision was 6/6 in both eyes (BES). The anterior segment was normal in BES except for mild periorbital edema in the right eye (RE). On applanation tonometry (AT), intraocular pressure (IOP) was 42 mmHg in RE and 36 mmHg in LE. Gonioscopy showed open angles in BEs. Fundoscopy and optical coherence tomogram–retinal nerve fiber layer were normal in BES. He was diagnosed with steroid-induced ocular hypertension in BES and was started on both topical and oral antiglaucoma medications (AGMs). IOP was normal after 2 weeks of treatment. He came after a month of discontinuation of AGMs against medical advice but was still on oral steroids. He was asymptomatic, but his IOP was 28 mmHg in RE and 26 mmHg in LE. Parents were counseled about the disease and need to restart AGMs. Regular follow-up was also emphasized.

Challenges of Secondary Glaucoma Management Following Congenital Cataract Surgery, Penetrating Keratoplasty and Vitreoretinal Surgery.

Glaucoma is one of the world's leading causes of irreversible vision loss. It is often asymptomatic until it reaches an advanced stage, which can have a significant impact on patients' daily lives. This paper describes the case of a 50-year-old female patient who presented with acute onset of ocular pain, photophobia, and loss of visual acuity in her right eye (RE). The patient's medical history includes congenital cataracts, surgical aphakia, nystagmus, strabismus, amblyopia, and secondary glaucoma. Ophthalmological examination showed BCVA RE-hand movement, left eye (LE)-0.08 with an intraocular pressure (IOP) of 30 mmHg in RE and 16 mmHg in LE. Biomicroscopic examination of RE showed corneal graft, epithelial and endothelial edema, endothelial precipitates, corneal neovascularization, aphakia, and Ahmed valve superotemporally. Despite maximal topical and systemic treatment, Ahmed valve, and trabeculectomy, secondary glaucoma in the right eye remained refractory. Reimplantation of an Ahmed valve was performed. This resulted in a favorable outcome with increased visual acuity and controlled intraocular pressure. The combination of aphakia, penetrating keratoplasty, and secondary glaucoma is a challenge for any surgeon. It is important that both the perioperative risks and the possible complications are carefully assessed in each patient, especially if associated pathology is present.

Ophthalmic Vein Thrombosis Associated with Factor V Leiden and MTHFR Mutations

Superior ophthalmic vein thrombosis (SOVT) is a rare clinical entity that may be associated with hypercoagulability status. We present a case of a 77-year-old woman who presented to the emergency department complaining of eye ptosis, chemosis and conjunctival congestion in the right eye (RE). The ophthalmological examination revealed best-corrected visual acuity (BCVA) was 0.5 for the right eye (RE) 0.5 and 0.06 for the left eye (LE). Intraocular pressure (IOP) was 25 mmHg in RE and 14 mmHg in LE. Non-contrast computed tomography (CT) of the brain and orbits revealed a hyperreflectivity at the level of the right ophthalmic vein and inferior rectus muscle hypertrophy. An extensive hypercoagulable panel was completed and we found a positive result for Factor V Leiden (heterozygous mutation) and methyl-enetetrahydrofolate reductase (MTHFR-C677T homozygous mutations). Systemic steroidal anti-inflammatory and anticoagulant treatments were started immediately. Gradual resolution of symptoms was noted during the hospitalization, and BCVA in her RE was established at 0.7 at the 10-week follow-up.

English

BACKGROUND Glaucoma is a chronic, progressive optic neuropathy leading to irreversible blindness. Raised intraocular pressure is one of the modifiable risk factors of developing glaucoma. Regulation of intraocular pressure (IOP) is influenced by various factors and, systolic hypertension is one of them. The objectives of the study was to assess the relationship between systolic hypertension and IOP, also to see the effect of controlled and uncontrolled systolic blood pressure (SBP) on IOP in adults above 40 years of age. METHODS This study included a total of 230 known systemic hypertensive patients of age above 40 years. All the patients underwent detailed history taking, careful systemic and ocular examination. IOP was measured by Goldmann applanation tonometer, central corneal thickness (CCT) by anterior segment optical coherence tomography (OCT) and blood pressure (BP) was recorded after 5 minutes of rest. The data was recorded. RESULTS Correlation coefficient for SBP and IOP in right eye (RE) was 0.290 and for left eye (LE) was 0.354 with a probability value of P < 0.0001 which was statistically highly significant. Mean IOP for controlled SBP was 17.76 mmHg in both eyes (BE) which increased to 20.19 mmHg in RE and 20.64 mmHg in LE in uncontrolled SBP. The Z score value between controlled and uncontrolled systolic hypertensive patients in RE and LE was 6.11 and 7.06 respectively (P < 0.0001). There was an increment of IOP for every 10 mmHg in SBP by 0.56 mmHg in right eye and 0.73 mmHg in left eye. CONCLUSIONS Systolic blood pressure is significantly correlated with IOP. The uncontrolled SBP was related to higher mean IOP and mean IOP was found to increase with rise in SBP. Therefore, patients with known hypertension and glaucoma have to be regularly followed-up and should keep their BP in normal range to prevent disease progression. KEYWORDS Intraocular Pressure, Central Corneal Thickness, Systolic Blood Pressure, Adults Above 40 Years

Multimodality imaging aided diagnosis of early zonular dehiscence following laser peripheral iridotomy

A 57-year-old man presented with diminution of vision in left eye (LE) for 2 days. He underwent both eyes laser peripheral iridotomy (LPI) once prior to his symptoms. On examination,...

Developmental glaucoma in a patient of ectrodactyly-ectodermal dysplasia.

A 23-year-old Indian female, already on intraocular pressure (IOP) lowering eye drops was referred for control of IOP. Systemic involvement was marked for coarse facial features [Fig. 1a], dental and skeletal abnormalities [Fig. 1c-g] suggestive of ectrodactyly-ectodermal dysplasia (EED). The right eye was in exotropia with no perception of light. The left eye had generalized nebular corneal opacification [Fig. 1b], wide-angle recess with numerous iris processes on gonioscopy, and visual acuity of 20/800. Applanation IOP was 28 mm Hg in the right eye and 46 mm Hg in left eye. Pachymetry and axial lengths were 523 μm and 24.32 mm, respectively in the left eye. Hazy view of fundus revealed glaucomatous optic disc changes.Figure 1: (a) Coarse facial features. (b) Dense corneal opacity in the right eye and the left eye with hazy cornea. (c) Oligodontia. (d) Orthopantomograph showing oligodontia with underdeveloped alveolar bone. (e and f) Ectrodactyly of hands. (g) Ectrodactyly and syndactyly of feetAfter lowering IOP with oral acetazolamide, Ahmed glaucoma valve FP7 (New World Medical, Inc CA) was implanted in superotemporal quadrant. The tube was placed in in the anterior chamber. At 4 months, full-thickness penetrating keratoplasty (PK) was done. In the early postoperative period vision was 20/1000 and IOP varied between 6 to 9 mm Hg [Fig. 2a]. At 7 months follow-up after PK, best-corrected visual acuity (BCVA) was 20/80 [Fig. 2b]. The corneal graft was clear but cataractous changes were noticed [Fig. 2c]. The IOP was 16 mm Hg, and the tube was well placed in the anterior chamber [Fig. 2d] with diffuse functional bleb [Fig. 2e]. The left eye fundus examination revealed average-sized disc with vertical cup-to-disc ratio of 0.75 and inferior rim thinning [Fig. 2f]. At 18-month follow-up, graft was clear, BCVA was 20/50, and IOP was 16 mmHg.Figure 2: (a) Some edema of the graft 1-week post-keratoplasty (b) Clear graft at 7-month follow-up (c) Clinically significant cataract. (d) Ahmed glaucoma valve FP7 tube in situ (white arrow) in the anterior chamber. (e) Bleb (red arrow). (f) Fundus photo depicting glaucomatous cupping in the left eyeDiscussion The reported ocular involvement in EED includes telecanthus, blepharophimosis, entropion, meibomian gland absence, atresia of lacrimal outflow tract components, ocular surface and tear film disorders, and keratopathy.[12] Infantile glaucoma has been reported with ectodermal dysplasia.[3] The absence of iris anomalies and presence of ectrodactyly differentiate this case from Axenfeld-Rieger syndrome.[4] Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Ocular biometric parameters are associated with non-contact tonometry measured intraocular pressure in non-pathologic myopic patients.

This research aimed to investigate effects and risk factors on non-contact tonometer (NCT) readings in healthy myopic subjects by employing cross-sectional study design. Totally, sixty otherwise healthy myopic volunteers (mean 28.4years old) with 90% female were recruited in ophthalmic clinic. The routine ophthalmic tests, refractive evaluation, examination central corneal thickness (CCT), depth of anterior chamber, axial length, corneal curvature, white-to-white and NCT were assessed at baseline. The linear-mixed model was utilized to evaluate correlation between the readings and ocular biometric parameters. For population in this study, mean spherical equivalents were - 4.85 ± 1.79 diopters in right eyes and - 4.63 ± 1.95 diopters in left eyes. Meanwhile, 28.3% of the eyes had a refractive error exceeding - 6.0 diopters. The mean NCT reading was 15.02 ± 3.02mmHg in left eyes and 15.33 ± 2.96mmHg in right eyes. Among the factors analyzed, CCT was the most significant parameter associated with NCT readings. After adjusting for the other factors, per one standard deviation increase of central corneal thickness (36.11μm) was associated a 1.14 (95% confidence interval 0.53-1.77) mmHg elevated NCT reading. The average central corneal curvature, age and spherical equivalence were also significantly and independently associated with NCT readings. Central corneal thickness, age, corneal curvature and degree of myopia were independently associated with NCT measured intraocular pressure. Central corneal thickness is one of the most influential factors.

Effects of sex, eye-side, diurnal variation on intraocular pressure in calves.

The aim of this study was to determine the effects of factors such as sex, eye-side and diurnal variation on intraocular pressure (IOP) values measured by Tono-Pen Vet® in healthy calves. Twenty four (12 males, 12 females) calves were used in this study. IOP measurements were per- formed in the morning (6:00 a.m.) and at night (8:00 p.m). Average IOP values in all calves were measured as 17.67±2.64 mmHg in the morning and 15.52±2.05 at night and the difference between these two time points was found to be statistically significant (p⟨0.0001). Average IOP values were measured as 16.04±2.82 mmHg in males and 17.15±2.23 mmHg in females with a statistically significant (p⟨0.05=0.023) difference between them. Average IOP values were 16.81±2.85 mmHg in right eyes and 16.37±2.23 mmHg in left eyes and the difference between these values were statistically insignificant (p>0.05). At the end of study, overall average IOP in all calves was measured as 16.59±2.59 mmHg. The present data showed a significant difference in terms of sex and diurnal variations and a non-significant difference in eye-side. In addition, this study is the first research article in which the intraocular pressure in calves was measured by Tono-Pen Vet®.

Senile eye disease screening program in downtown Wenzhou: intraocular pressure

Objective: To investigate the distribution and related factors of intraocular pressure (IOP) in the screened population aged over 50 years in Wenzhou. Methods: This study included 31 170 community residents aged 50 years or older in Wenzhou undergoing screening from March 2014 to January 2016. Participants underwent a complete ocular examination, including visual acuity, eye-ground photography, slit lamp and standardized measurement of IOP by non-contact tonometry. Subjects who had undergone ocular operation or laser peripheral iridectomy, had glaucoma, corneal or other ocular diseases that could possibly affect the IOP, had an IOP lower than 6 mmHg(1 mmHg=0.133 kPa) and visual acuity less than 0.3, or had monocular IOP values were excluded. The relationship between IOP and various parameters were analyzed. Results: A total of 20 875 subjects (6 902 males and 13 973 females) were enrolled in the current analysis, including 18 677 healthy persons and 2 125 glaucoma suspects, with an average age of (67.3±8.7) years old. The mean IOP (mean±standard deviation) of the healthy population was (13.5±3.0) mmHg (13.4±3.2) mmHg in right eyes and (13.6±3.3) mmHg in left eyes; 2.04% of the left eyes, 1.51% of the right eyes and 2.92% of either eyes of healthy population had an IOP >21 mmHg. The mean IOP in glaucoma suspects was significantly higher than that in the healthy population (P<0.001); 6.78% of the left eyes, 6.16% of the right eyes and 9.65% of either eyes of glaucoma suspects had an IOP >21 mmHg. Men had lower IOPs than women [healthy population: (12.9±3.2) mmHg versus (13.7±3.2) mmHg; P<0.05]. The linear function of IOP (Y) with age (X(1)) and the vertical cup disc ratio (X(2)) was ^Y=15.962-0.043X(1)+0.837X(2)(P<0.05) in the healthy population. Conclusion: The IOP among healthy persons aged over 50 years living in downtown Wenzhou was decreased with age but increased with the vertical cup disc ratio. The IOP in females was higher than that in males. About 3% of the healthy population had an IOP greater than 21 mmHg. (Chin J Ophthalmol, 2018, 54: 586-592).

West Indies Glaucoma Laser Study (WIGLS): 1. 12-Month Efficacy of Selective Laser Trabeculoplasty in Afro-Caribbeans With Glaucoma

To characterize the 12-month intraocular pressure (IOP)-lowering efficacy of selective laser trabeculoplasty (SLT) as sole therapy for primary open-angle glaucoma (POAG) in an Afro-Caribbean population. Stepped-wedge trial. Subjects in St. Lucia and Dominica with established POAG were randomized to prompt washout of IOP-lowering medications followed by SLT, 3-month delay followed by washout and SLT, or 6-month delay followed by washout and SLT. Baseline IOP was obtained on 2 different days after washout. Bilateral 360-degree SLT was performed in 1 session. Posttreatment assessments took place 1 hour, 1week, and 3, 6, 9, and 12months post-SLT. The main outcome measure was SLT success (defined as IOP ≤ target IOP in both eyes) at 12months. Target IOP was a 20% or greater reduction in IOP from postwashout baseline. Overall, 72 patients underwent SLT treatment. Mean IOP at enrollment was 15.4 ± 3.6mm Hg in right eyes and 15.4 ± 3.6mm Hg in left eyes, which rose to 21.0 ± 3.3mm Hg and 20.9 ± 3.0mm Hg, respectively, after washout. Mean IOP at 3, 6, 9, and 12months ranged from 12.5mm Hg to 14.5mm Hg (29.7% to 39.5%; P < .0001 in each eye at each time point). The 12-month success rate was 78%. Transient photophobia and discomfort were common. SLT monotherapy safely provides significant IOP reduction in Afro-Caribbean eyes with POAG. This treatment can play a significant role in preventing glaucoma vision loss and blindness in people of African descent living in resource-limited regions.

Unilateral painful external ophthalmoplegia as the first manifestation of combined anterior and posterior scleritis

PurposePosterior scleritis (PS) is a rare form of ocular inflammation. It can be idiopathic or associated with systemic disorders in 40%–50% of cases. PS is characterized by several different clinical manifestations like severe pain especially during eye movements and in some cases decreased vision. It can include changes in choroid, retina and optic nerve and associate anterior scleritis. We present a case of unilateral painful ophthalmoplegia as the first manifestation of combined anterior and posterior scleritis.MethodsAn otherwise healthy 55‐year‐old man complained with acute diplopia and painful ophthalmoplegia in his left eye. Findings on examination were conjunctival quemosis, moderate hyperemia and limitation of ocular movements in all directions. Best‐corrected visual acuity (BCVA) was 20/20 in both eyes. Goldmann applanation intraocular pressure was 18 mmHg in right eye and 28 mmHg in left eye. Fundus examination was normal. Contrast‐enhanced CT scan showed marked anterior and posterior scleral thickening of the left eye. In the systemic examination, routine blood tests, autoimmune and infectious markers were normal.ResultsTreatment was initiated with oral prednisolone 1 mg/kg/day. After 7 days, the patient′s signs and symptoms had improved. Following one month of treatment scleritis had disappeared. One year later, the patient is asymptomatic without any recurrences.ConclusionsOpthalmologist should be aware of the possibility of a misdiagnosed posterior scleritis in a patient with clinical settings of anterior scleritis like diplopia or ophthalmoplegia.

Icare ONE Home Tonometry in Children With and Without Known Glaucoma.

The Icare ONE (Finland Oy) rebound tonometer may have promise for home tonometry in children with glaucoma. The purpose of this study was: (1) to assess the feasibility of Icare ONE home tonometry in a small number of children with and without glaucoma and (2) to characterize diurnal intraocular pressure (IOP) variations in children with and without glaucoma. Patients were recruited from Duke pediatric ophthalmology clinic. Parents underwent in-clinic training for Icare ONE tonometry. Parents were instructed to record the subject's IOP using Icare ONE at 6 time intervals daily for 10 sequential days. Eight normal subjects (16 eyes) and 10 subjects (10 eyes) with glaucoma were included. All parents successfully performed Icare ONE home tonometry. In-clinic Icare ONE IOP exceeded Goldmann applanation in both groups. Normal subjects (mean age, 11.8 y) had a mean daily IOP range of 4.8 ± 4.6 mm Hg for right eyes and 5.2 ± 1.7 mm Hg for left eyes, and demonstrated relative peaks in the morning and relative troughs in the evening. Subjects with glaucoma (mean age, 12.4 y) had a mean daily IOP range of 8.6 ± 8.2 mm Hg, and demonstrated an even distribution of relative peaks and troughs throughout the day. Icare ONE home tonometry seems feasible in a small number of children. Normal eyes demonstrated smaller daily IOP ranges than glaucomatous eyes. Normal eyes were also more likely to show a relative early morning IOP peak and a late evening IOP trough. It is likely that the limited sampling in this study limits its generalizability to all children with glaucoma or to normal children.

Posner schlossman syndrome - A case report

A 23 year old female patient presented to Ophthalmology OPD with complaints of left sided headache since one month, it was sudden in onset and was associated with redness, watering, photophobia and blurring of vision. There were about 8-10 episodes, each lasted for 1-2 days with asymptomatic period between the attacks. Left eye showed fine keratic precipitates with grade 2 flare and cells in anterior chamber. Pupils were mid-dilated and sluggishly reacting. IOP in left eye was 38 mmHg. Patient was started on topical steroids, oral Acetazolamide and topical anti glaucoma medication. Patient was followed after 3 days, showed decrease in inflammation and IOP of 22.00mm Hg in left eye, Gonioscopy revealed open angles and Humphreys visual field test showed no obvious visual field defects. Dilated fundus examination showed normal optic discs. Patients were followed regularly for IOP and any obvious optic disc and visual field defects.

Combined Intraocular Silicone Prosthesis and Conjunctival Flap for Glaucoma after Corneal Perforation in a Dog

A 7-month-old intact male Maltese dog was presented with a 1.5-month history of glaucoma in the right eye (OD). Ophthalmic examinations revealed a corneal perforation with iris entrapment, corneal edema and neovascularization, and buphthalmos OD. Intraocular pressures were 33 mmHg OD and 19 mmHg in left eye (OS). The right eye was diagnosed with chronic glaucoma and corneal perforation with iris entrapment. Now that the eye was blind, implantation of intraocular silicone prosthesis (ISP) and conjunctival flap were elected to salvage the globe. The corneal perforation healed with the conjunctival pedicle flap and the cornea accommodated the ISP properly. A satisfactory cosmetic result was achieved without complications in the 15 months following the procedure. Therefore, this case report indicates the combined an ISP and a conjunctival flap would be an alternative for the treatment of glaucoma associated with corneal perforation in dogs.

Presentation of glaucoma in the greater Accra metropolitan area of Ghana.

This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area. This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011. The definition of POAG conformed to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Information collected included basic demographic data, distribution of glaucoma subtypes, measured intraocular pressure (IOP), best corrected visual acuity (BCVA) and optic disc measurements. Nearly 24% presented blind in at least one eye. The average age was 56.7 +/-16.7 years and the average IOP was 33.9 mmHg +/- 12.7 mmHg for right eyes and 33.5 mmHg +/-12.0 mmHg for left eyes. The mean vertical cup to disc ratio (vCDR) was 0.83 for right eyes versus 0.82 for left eyes. A total of 32 patients (53 eyes) were diagnosed with normal tension glaucoma (NTG). Statistically significant differences between the NTG and high tension groups included age (45.3 +/- 16.7 vs. 56.7 +/-16.7, p<0.001), mean IOP (19.1 mmHg +/- 4.5 mmHg vs. 33.7 +/- 12.4 mmHg, p<0.001) and mean vCDR (0.76 +/- 0.17 vs. 0.83 +/-0.10, p<0.01). Comparing age-matched NTG patients with high tension glaucoma patients showed no significant difference in vCDR. The clinical presentation of POAG at the Emmanuel Eye Center is characterized by elevated IOP and grossly advanced optic neuropathy. Significant differences between high tension glaucoma and NTG were identified.

Distribution of Intraocular Pressure and Its Association with Ocular Features and Cardiovascular Risk Factors: The Gutenberg Health Study

To describe the distribution of intraocular pressure (IOP) and its association with ocular features and cardiovascular risk factors in an adult European cohort. Population-based, cross-sectional study. This analysis was based on a Gutenberg Health Study (GHS) cohort that included 4335 eligible enrollees from among 5000 subjects who participated in the survey from 2007 through 2008. The age range was 35 to 74 years at enrollment. Participants underwent a standardized protocol with a comprehensive questionnaire; ophthalmic examination including slit-lamp biomicroscopy, noncontact tonometry, fundus photography, central corneal thickness measurement, and visual field testing; and a thorough general examination focused on cardiovascular parameters, psychological evaluation, and laboratory tests, including genetic analysis. Mean and reference interval of IOP stratified by age, gender, and eye. Mean ± standard deviation (SD) IOP was 14.0 ± 2.6 mmHg in both eyes, 13.9 ± 2.7 mmHg in right eyes, and 14.0 ± 2.7 mmHg in left eyes. Mean ± SD IOP in men (n = 2216) and in women (n = 2119) was 14.1 ± 2.7 mmHg and 13.9 ± 2.5 mmHg with an intersex difference (P = 0.009). Positive univariate associations with higher IOP were detected for brown iris color, central corneal thickness, hypertension, diabetes, smoking, obesity, dyslipidemia, body mass index, weight, hip size (women only), waist circumference, and waist-to-hip ratio. Multivariate testing revealed male gender, central corneal thickness, brown iris color, hypertension, smoking, and waist-to-hip ratio to be correlated with higher IOP. In women, age correlated negatively with IOP in the multivariate analysis. Intraocular pressure distribution in this cohort yielded a lower mean IOP than in similar white study populations. Increasing age in women correlated with lower IOP. Association analyses with several systemic characteristics revealed that cardiovascular risk factors correlated with higher IOP. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

The correlation between body mass index and intraocular pressure in children

There is evidence from some studies that support an association between obesity in adults and higher intraocular pressure (IOP). However, this association has not been completely studied in children. Our aim is to evaluate the association between child body mass index (BMI) and IOP. Ninety-six children attending the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) in Brazil were studied. Thirty-three were overweight/obese with a mean BMI of 29.7 ± 5.2 and 63 with a mean BMI of 20.8 ± 3.3. IOP was measured using the Goldmann applanation tonometer and was corrected for corneal thickness. The coefficient of correlation between BMI and IOP was calculated. There was no significant difference in the IOP of children with or without overweight/obesity. The mean IOP was 13.5 and 13.0 mmHg for the right eye and 13.1 and 12.9 mmHg for left eye, respectively (p=0.38 and p=0.71). The results remained the same after correction by pachymetry; 13.0 and 13.1 mmHg for the right eye and 12.4 and 12.9 mmHg for the left eye, respectively (p=0.88 and p=0.41). The coefficient of correlation between BMI and IOP was 0.070 (p=0.496). These results do not show a correlation between body mass index and IOP in children. Further studies are warranted to clarify the association between BMI and IOP in children.

Intraocular pressure as indicator of sympathetic asymmetry in the eyes.

To determine the asymmetry in the sympathetic activity in the eyes as indicated by intraocular pressure (IOP). In a prospective cross sectional study, the IOP in 150 newborns, 80 young adults and 159 old people was measured with Tono-Pen under topical anaesthesia. The mean IOP in the newborns was 16.16mmHg in right eye and 15.79mmHg in left eye; in young adults 15.04mmHg in right eye and 14.71 in left eye; in old people 15.16 in right eye and 15.03 in left eye. A statistically significant higher IOP was noted in the right eye in the newborns (P=0.03) and in young adults (P=0.02), but not in the old people (P=0.26). The higher IOP in the right eye indicates the lowered sympathetic activity in that eye. We hypothesize that the sympathetic asymmetry in the bilaterally placed organs helps to establish the dominant pattern of the organ in the body.

Fluktuationen des intraokularen Augendrucks – ein intraindividueller Vergleich zwischen 24-Stunden-Teletonometrie-Monitoring und ambulanter Augendruckmessung

Elevated intraocular pressure (IOP) is a clinically relevant factor in glaucoma progression. As a dynamic parameter the IOP depends on various internal and exogenic influencing factors. Therefore, we analysed intraindividual IOD variations between ambulant care and 24-h home-monitoring using self-tonometry. This study is based on paper-based glaucoma cards of 25 patients with primary open angle glaucoma. Additionally, all patients participated in a telemedical home-monitoring study with self-measurements of IOP and blood pressure stored in an electronic patient record. The glaucoma cards contained a total number of 409 IOP values with documentation periods from 0.5 to 10 years. In the teletonometry project all 25 patients were observed for 6 months with 1490 recorded IOP values. Statistical analysis was performed with SPSS software. Average IOP values for all 25 glaucoma patients were 16.3 +/- 2.9 mmHg for both eyes in glaucoma card documentation, whereas the electronic patient records showed IOP averages of 18.9 +/- 4.7 mmHg for right eyes and 18.2 +/- 4.4 mmHg for left eyes. Corresponding to the practice opening hours the glaucoma cards contained no IOP records from 12:00 pm to 01:30 pm as well as between 06:00 pm and 07:15 am. In these time periods 17 % of all IOP values recorded in 24-hour teletonometry were higher than 20 mmHg. However, statistical analysis and clinical evaluation of device parameters and measurement characteristics revealed sporadic measuring errors. The additional involvement of self-tonometry in telemedical 24-h home-monitoring is a feasible method to record and detect intraday IOP fluctuations. Compared to single IOP measurements documented in common paper-based glaucoma cards, the 24-h electronic patient record showed more frequent circadian IOP variations. As a result, self-tonometry and home-monitoring can be a useful link to fill the gap between singular ambulant IOP measurement and hospitalisation with 24-hour IOP profiles.