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Erik L. GreveIs there such a thing as THE IOP of a patient? Or THE IOP at which a visual field deteriorated? Not only has IOP its own circadian fluctuation, it also changes under a multitude of circumstances. Stand on your head and IOP doubles. An exception? Not if you are engaged in yoga exercises. Indeed in 75 yoga afficionados Baskaran et al. (abstract no. 698) found a two-fold increase of IOP when they were performing their head-down exercises. The article does not mention any glaucoma in these participants. A famous case of glaucoma after yoga head-down position was reported in the JoG many years ago. Subsequently, many controlled studies on IOP in head-down position have been published. Some exercise lowers IOP as was reported in IGR 8-2; other exercises, such as weight-lifting, may raise IOP. Vieira et al. (abstract no. 711) report on IOP increase of more than 4 mmHg during bench-press and breath-holding. The above publications are two of a host of publications on all sorts of influences on IOP. So what is your IOP if you are a gardener and lifting heavy flower-pots regularly? Certainly not the IOP measured in the ophthalmologists's office. What is your IOP after three beers and/or a glass of whisky? What after exercise, what after intercourse? And so on. The above serves to illustrate how poor our knowledge is of the IOP over time in the individual patient. |
