Survey of Ophthalmology
Volume 55, Issue 5 , Pages 445-453, September 2010

Posture-induced Intraocular Pressure Changes: Considerations Regarding Body Position in Glaucoma Patients

  • Tiago Santos Prata, MD

      Affiliations

    • Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
    • Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    • ,
  • Carlos G.V. De Moraes, MD

      Affiliations

    • Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    • ,
  • Fabio N. Kanadani, MD

      Affiliations

    • Department of Ophthalmology, Santa Casa of Belo Horizonte, Minas Gerais, Brazil
    • ,
  • Robert Ritch, MD

      Affiliations

    • Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York, USA
    • Corresponding Author InformationReprint address: Robert Ritch, MD, Einhorn Clinical Research Center, Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY 10003.
    • ,
  • Augusto Paranhos Jr., MD, PhD

      Affiliations

    • Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil

published online 20 July 2010.

Abstract 

Although glaucoma is a multifactorial disease, elevated intraocular pressure (IOP) remains the most important known risk factor. Different systemic and local factors are thought to influence an individual's IOP. There can be a clinically significant rise in IOP when going from upright to horizontal or inverted body positions. Although there is a significant interindividual variability, the magnitude of the IOP change is greater in glaucomatous eyes. As patients usually spend a significant portion of their lives in the horizontal position, mainly during sleep, this is highly relevant. In this review we discuss the relationship between postural changes and IOP fluctuation, including changes in both body and head position. The possible mechanisms involved and the main implications for glaucomatous eyes are discussed. Finally, considerations with regard to sleep position in glaucoma patients are made based on evidence in the literature.

Key words: glaucoma, head position, intraocular pressure fluctuation, postural changes, sleep time, supine position

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 The authors reported no financial or proprietary interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(09)00313-0

doi:10.1016/j.survophthal.2009.12.002

Survey of Ophthalmology
Volume 55, Issue 5 , Pages 445-453, September 2010

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