Intraocular pressure--the cardiac connection

A retrospective analysis of graphic intraocularpulse waves (IOPW) taken with a pneumotonograph (PTG) revealed abrupt elevations of intraocular pressure (IOP) in a strict-time relationship with the onset of spontaneous or sustained cardiac tachyarrhythmias. This may be explained as a consequence of an increase in central venous pressure from the "back" pressure effect of abnormal diastolic indexes of cardiac function rather than the forward systolic forces (including systolic blood pressure that usually are depressed under these circumstances). Given the frequency of cardiac arrhythmias in the general population, we suggest that continuous graphic IOP tracings, such as with the PTG, will reflect overall IOP levels better than those obtained, for example, by a quick-acting noncontact tonometer. Abnormal indexes of diastolic cardiac function found in many forms of heart disease, including the aging process, merit further consideration as a potential cardiovascular factor affecting ocular pressure dynamics in other circumstances.