Abstract
Purpose:
To study whether a clinically significant increase in intraocular pressure (IOP) occurs during simulated sleep conditions with the subject’s head turned comfortably into a pillow (the simulated sleep position) and the effect of protective goggles on any such IOP rises.
Methods:
A specially developed electronic epipalpebral pressure (EPP) sensor was attached to an eyelid of the right eye of all participants. During calibration, pressure was applied to the EPP sensor and the IOP was measured simultaneously at the slitlamp by Goldmann applanation tonometry. The EPP was increased in a stepwise fashion to assess the relationship between EPP and IOP for each individual eye. Thereafter EPP measurements were performed in the simulated sleep position and in the simulated sleep position with protective goggles. The EPP was determined in each individual eye and the estimated IOP was then inferred from the established EPP/IOP relationship.
Results:
In the simulated sleep position, the mean IOP increased by an estimated 17.9 mmHg (SD 9.1; range 21.1, P<0.0001) in the patient group and 28.1 mmHg (SD 9.5; range 28.8, P<0.0001) in the control group. When the subjects wore protective goggles, the estimated IOP decreased again by 17.2 mmHg (SD 6.2; range 18.3, P<0.0001) in the patient group and 25.2 mmHg (SD 8.1; range 26.5, P= P<0.0001) in the control group.
Conclusions:
Turning the head into a pillow gave a large and clinically significant rise in the estimated IOP in the simulated sleep position. With protective shielding, however, the rise in estimated IOP was almost absent. Therefore, protective shielding of the eyes during sleep may be a significant treatment option in glaucoma.<br />