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Attempted eyelid closure affects intraocular pressure measurement
P D Gandhi1, R Gürses-Ozden, J M Liebmann
1Mount Sinai School of Medicine of New York University, New York, New York, USA.
American Journal of Ophthalmology
|April 9, 2001
Summary
Attempting to close your eyelids during intraocular pressure (IOP) measurement can significantly elevate readings. This common error, measured with Goldmann applanation tonometry and Tono-pen XL, may impact glaucoma management.
Area of Science:
- Ophthalmology
- Optometry
- Clinical Measurement
Background:
- Intraocular pressure (IOP) measurement is crucial for diagnosing and managing glaucoma.
- Accurate IOP readings are essential for effective clinical decision-making.
- Potential sources of error in IOP measurement require thorough investigation.
Purpose of the Study:
- To investigate the impact of attempted eyelid closure on IOP measurements.
- To determine if forced eyelid closure introduces a statistically significant error.
- To compare the effects of eyelid closure using two different tonometry devices.
Main Methods:
- Normal subjects underwent IOP measurement using Goldmann applanation tonometry and Tono-pen XL.
- Measurements were taken with and without simultaneous forced eyelid closure.
- Examiners ensured eyelids were held open during measurement, randomizing the order of procedures.
Main Results:
- Attempted eyelid closure increased IOP by a mean of 1.5 mmHg (Goldmann) and 1.9 mmHg (Tono-pen XL).
- These increases were statistically significant for both tonometry methods (P =.0002).
- Tono-pen XL consistently overestimated IOP compared to Goldmann applanation tonometry.
Conclusions:
- Attempted forced eyelid closure is a common and significant source of error in routine IOP measurement.
- This error can potentially influence the clinical management of glaucoma.
- Awareness and avoidance of this error are important for accurate IOP assessment.