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Editors Selection IGR 13-3
Risk Factors: Does ambient atmospheric pressure affect everyday IOP readings?
Comment by Arthur Sit on:
126563 Effects of ambient atmospheric pressure on intraocular pressure measured using a Goldman applanation tonometer in normal eyes under ordinary conditions, Ikushima T; Iwase A; Araie M et al., Graefe's Archive for Clinical and Experimental Ophthalmology, 2025; 263: 1391-1398
Variations in intraocular pressure (IOP) are influenced by both intrinsic (such as age, corneal thickness, and blood pressure) and extrinsic (such as environmental and climatic) factors, and understanding these variations is key for glaucoma risk assessment and management. [1] Previous studies have shown that IOP can be affected by atmospheric pressure (AP), with some reporting that acute changes—such as those experienced by climbers at high altitude or during hyperbaric chamber experiments—produce significant decreases or, in some cases, increases in IOP. [2, 3]
Unlike these prior studies, which focused on acute, experimentally induced AP changes, the recent work by Ikushima et al. (2025) is noteworthy for investigating the effect of everyday, natural fluctuations in AP on IOP measured using Goldmann applanation tonometry (GAT-IOP) in normal, healthy eyes under ordinary conditions in a large, real-world Japanese population. By adjusting for a broad range of ocular, systemic, and climatic confounding factors, the authors’ analysis found a statistically significant positive relationship between AP and GAT-IOP (standardized regression coefficient R=0.1142), but the association was weak. Specifically, the coefficient of determination (R2=0.013) indicates that only about 1.3% of the variability in IOP can be explained by AP, emphasizing its minor practical impact in ordinary conditions. The study also confirmed that central corneal thickness, body mass index, and systolic blood pressure were positively correlated with GAT-IOP, while corneal curvature radius and age were negatively correlated. Seasonal variation also had a significant impact, with IOP being lower in summer and higher in spring compared to winter.
This distinction underscores the unique contribution of Ikushima et al.’s study: it analyzes the subtle, chronic effects of atmospheric pressure variation, rather than just acute, dramatic shifts, broadening our understanding of how everyday environmental factors might influence ocular physiology. While the results are statistically robust, they reinforce that for most healthy individuals, environmental AP is a comparatively minor determinant of IOP. The authors suggest further research is needed to fully understand the mechanisms driving these effects and to investigate the influence of regional climate variations. The study contributes to a growing body of knowledge aimed at refining our understanding of IOP regulation in healthy individuals.
References
- Klein, B., R. Klein, and K. Linton, Intraocular pressure in an American community. The Beaver Dam Eye Study. Investigative ophthalmology & visual science, 1992. 33(7): p. 2224-2228.
- Pavlidis, M., et al., Intraocular pressure changes during high-altitude acclimatization. Graefe's Archive for Clinical and Experimental Ophthalmology, 2006. 244(3): p. 298-304. https://doi.org/10.1007/s00417-005-1174-1
- Somner, J.E., et al., What happens to intraocular pressure at high altitude? Investigative ophthalmology & visual science, 2007. 48(4): p. 1622-1626. https://doi.org/10.1167/iovs.06-1238
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