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Abstract #78272 Published in IGR 19-4
Effects of different sleeping positions on intraocular pressure in secondary open-angle glaucoma and glaucoma suspect patients
Sedgewick JH; Sedgewick JA; Sedgewick BA; Ekmekci BClinical Ophthalmology 2018; 12: 1347-1357
PURPOSE: The aim of this study was to investigate the effects of different recumbent sleeping positions of the head and body on intraocular pressure (IOP) in secondary open-angle glaucoma and glaucoma suspect patients, specifically pigmentary dispersion (PD) as measured using the ICare rebound tonometer. PATIENTS AND METHODS: A total of 44 eyes of 24 patients with PD were selected in this study. The IOP of 44 eyes was measured in the initial seated position, in the 4 recumbent positions, and again in the sitting position between each of the recumbent positions. RESULTS: The IOP of the right eyes and left eyes was higher in each of the 4 recumbent positions compared to its initial sitting position (all <0.001). Dependent (D) vs nondependent (ND) comparisons failed to show a significant difference. All lateral vs prone comparisons showed a higher average IOP in the prone position than in the lateral position regardless of D vs ND status. The range of recumbent IOP changes was -4 to +17 mmHg or -17% to +142%. A total of 64% had at least a ≥33% IOP increase with 43% having a ≥50% increase. CONCLUSION: Lateral and prone sleeping positions usually do result in significant elevations of IOP in PD patients. Dependency status did not make a difference. A significantly larger IOP increase was seen in the prone position than in the lateral position. The presence of 3 clinical variables (disk hemorrhage [DH], notches, and BV changes) might increase the chances of developing a large recumbent increase in IOP. These patients and possibly all PD syndrome (PDS) or PD glaucoma (PDG) patients should consider sleeping in a bed that allows a head elevation of 30°.
Private Practice, Ashburn, Virginia, dr.sedgewick@gmail.com.
Full articleClassification:
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
9.4.3.1 Pigmentary glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.3 Glaucomas associated with disorders of the iris and ciliary body)