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IOP measurement influenced by eyelid closure

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NEW YORK — Patients' attempts to close their eyelids during tonometry produce a common and statistically significant source of error in intraocular pressure measurement, according to a study done here.

To measure the effect of attempted eyelid closure on intraocular pressure (IOP) measurement, Robert Ritch, MD, and colleagues examined 30 eyes of 15 normal volunteers. All eyes had refractive errors between -4.25 D and +0.75 D in both eyes; astigmatism was -0.5 D or less in all participants. All participants had IOP measured by the same examiner.

The examiner held the eyelids open against the orbital rim, and IOP was measured with the volunteers being asked to try and force their eyelids closed and without being asked to force eyelid closure.

"With both Goldmann applanation tonometry and Tono-pen XL, IOP increased in both eyes when subjects attempted maximal forced eyelid closure that still permitted tonometry," Dr. Ritch told Ocular Surgery News.

As a result, said Dr. Ritch, if the patient is uncooperative, neither instrument will be more effective in measuring IOP. This may be clinically significant for some patients, he added.

A more detailed report on the study can be found in the Oct. 1, 2001, edition of Ocular Surgery News.