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Intraocular pressure and mechanical ventilation

D S Johnson1, D J Crittenden

  • 1Department of Health Sciences, University of Central Florida, Orlando.

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|July 1, 1993
PubMed
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Mechanical ventilation can increase intraocular pressure (IOP), especially at high peak inspiratory pressures. This may pose a risk for vision impairment in patients on long-term mechanical ventilation.

Area of Science:

  • Ophthalmology
  • Critical Care Medicine
  • Physiology

Background:

  • Mechanical ventilation is known to increase central venous pressure.
  • Elevated central venous pressure theoretically increases episcleral venous pressure and intraocular pressure (IOP).
  • The direct impact of varying mechanical ventilation parameters on IOP requires further investigation.

Purpose of the Study:

  • To investigate the effect of mechanical ventilation on intraocular pressure (IOP).
  • To determine if low and high peak inspiratory pressures during mechanical ventilation differentially affect IOP.
  • To assess the potential risk of vision impairment due to machine-induced IOP elevation.

Main Methods:

  • Intraocular pressure (IOP) was measured using a Keeler Pulsair Non Contact Tonometer in six healthy subjects.

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  • Subjects underwent a 30-min control period of supine spontaneous ventilation.
  • Subsequent periods involved supine mechanical ventilation with low (7-15 cm H2O) peak inspiratory pressures, followed by a brief (1 min) application of high (60 cm H2O) peak inspiratory pressures.

    • Main Results:

    • Low peak inspiratory pressures during mechanical ventilation did not significantly alter IOP compared to spontaneous ventilation.
    • A short duration of high peak inspiratory pressures (60 cm H2O) resulted in a statistically significant increase in IOP (32.7%, p < 0.05).
    • No subjects had a history of glaucoma or ocular hypertension.

    Conclusions:

    • Mechanical ventilation, particularly at high peak inspiratory pressures, can acutely increase intraocular pressure (IOP).
    • Patients requiring prolonged mechanical ventilation with high pressures may face an elevated risk of vision impairment.
    • Further research is warranted to understand the long-term implications and clinical management strategies for ventilation-induced IOP changes.