Measure eye pressure. Methods for measuring intraocular pressure. Means for internal use
![Measure eye pressure. Methods for measuring intraocular pressure. Means for internal use](https://i0.wp.com/proglaza.net/wp-content/uploads/2019/06/izmerenie-vnutriglaznogo-davleniya-3.jpg)
For the diagnosis of most ophthalmic (and not only) diseases, measurement of intraocular pressure is required. IOP is especially important for confirming glaucoma. The indicator can be normal, high or low, and this affects the functioning of not only the organ of vision, therefore, there are several methods for measuring it.
cool
Send
What is VGD?
Intraocular pressure is the fluid pressure inside the eye, or the force with which the contents of the eyeball presses against its walls. This force is necessary to maintain the shape and anatomy of the eye, as well as to control the supply of nutrients to all parts of the organ and regulate blood flow.
Normally, the indicator ranges from 10-25 mm Hg.
IOP should be monitored regardless of the state of eye health. Even if a person has excellent vision and does not feel any discomfort, a deviation from the norm may be detected during the examination. This is fraught with unpleasant consequences, so it is better to prevent their development in time.
The method of measuring the indicator in ophthalmology is called tonometry.
Classification
Intraocular pressure is normal, high and low. Ophthalmologists allow slight fluctuations in IOP during the day, and these fluctuations are the physiological norm. A stable significant deviation up or down is considered a pathology.
Increased intraocular pressure in medical practice is more common. In medical language, this disorder is called ocular hypertension. Its main manifestation is glaucoma, a disease that occurs if a person does not follow the IOP.
Elevated IOP is further divided into 3 varieties:
- stable- constantly high pressure inside the eye;
- labile- periodic increase in the indicator;
- transitory- single short-term jump.
Low blood pressure, or ocular hypotension, is diagnosed less frequently, but poses a great threat to the health of not only the eyes, but the body as a whole.
When can a change in indicators be observed?
Ophthalmotonus fluctuations are physiological or pathological.
Physiological fluctuations are bound to occur within one day. In the morning, the indicator may be slightly higher than normal, stay at an average level during the day, and decrease in the evening. This is due to the fact that the eyes are tired by the end of the day, and they need rest.
REFERENCE! The norm is a change in pressure of no more than 3 mm Hg.
Physiological abnormalities are possible under other circumstances:
- Intensive sports. Depending on the characteristics of the exercises performed, IOP can both rise and fall.
- Playing some musical instruments. Studies have been conducted that have shown that playing wind musical instruments (brass and wood) contributes to an increase in intraocular pressure. This relationship is explained by the presence of intraoral resistance.
Temporary changes in IOP can be associated with certain medications, increased heart rate and breathing, fluid intake, alcohol, caffeine. The use of glycerin can cause a temporary sharp decrease in intraocular pressure.
Significant deviations from the norm are always associated with pathological processes that can lead to anatomical and functional defects of the organs of vision. High blood pressure can be both a cause and a consequence of the following diseases:
- glaucoma;
- inflammatory processes of the iris and choroid;
- disorders in the work of the kidneys;
- heart failure;
- Graves' disease (diffuse toxic goiter);
- hypothyroidism;
- tumors and eye injuries.
An increase in ophthalmotonus is possible in women during menopause, as well as in case of poisoning with chemicals and certain drugs.
When different IOP values are possible in different eyes.
In the early stages of these pathologies, labile is fixed, i.e. periodic increase in IOP. In advanced cases, the indicator is always above the norm.
Downward pressure change is possible:
- after surgical interventions;
- as a result of injury;
- due to the anatomical features of the structure of the eye;
- due to detachment of the retina or choroid;
- due to low blood pressure.
In both cases, treatment is required, because consistently high or low pressure is fraught with serious complications.
Useful video
How to measure eye pressure?
What dangers are fraught with violations of IOP?
Constantly increased or decreased intraocular pressure means that the metabolic processes of the eyes are disturbed: the structural parts of the organ do not receive enough oxygen and nutrition, the blood supply is changed. As a result, the optical properties of the retina, the characteristics of the choroid and other elements of the eye change, which can lead to a number of complications:
- glaucoma is a dangerous disease that is difficult to treat;
- atrophy of the optic nerve;
- severe decrease in vision;
- blindness.
Moreover, if with increased pressure there is a chance to improve the condition of the visual analyzer and partially restore vision, then with a reduced indicator, irreversible changes occur.
Devices for determining IOP
With certain symptoms, a diagnosis of IOP is prescribed. It is carried out in different ways, depending on what equipment the clinic is equipped with.
REFERENCE! Each device for measuring IOP has its own norm indicators.
Reichert apparatus for determining ophthalmotonus indicators
With this device, the degree of thickening of the cornea is analyzed without discomfort and pain. The procedure itself goes like this: the patient sits down, leaning his head against the device, and fixes his gaze in a certain position.
The device makes several air "shots" on the cornea, after which the results are displayed on the display.
Goldmann tonometer
This is a device that works on the principle of applanation tonometry. The procedure itself is not very pleasant, although it is not felt by the patient due to the use of anesthesia. In addition to anesthetic drops, you will need a special coloring solution.
The slit lamp is used for better visual control.
A device equipped with a prism is applied close to the cornea. When he squeezes it, the image is divided into 2 parts. The ophthalmologist adjusts the intensity of pressure until the half-rings of the image form a single whole.
The Goldmann tonometer determines how much force must be used to flatten the cornea.
Tono-Pen
Tono-Pen is a small device slightly larger than a regular pen, which must be attached to the eyeball. The result is immediately displayed on the display, however, the procedure itself is unpleasant, so anesthesia is required.
Electronograph
A device that allows you to diagnose glaucoma at an early stage. The procedure itself takes no more than 5 minutes: a sensor is installed on the cornea of the eye, which reflects the changes in IOP on the graph.
Portable devices
Portable devices are lightweight, compact and small in size. They are recommended for people for whom it is important to constantly monitor IOP, for example, those who have an increased risk of developing glaucoma.
REFERENCE! Portable devices operate without being connected to the mains.
One of the most affordable and widespread portable devices for measuring intraocular pressure is the ICare device with disposable sensors that are alternately applied to the cornea and give a very accurate result.
Portable devices include Reichert, TVGD-2, IGD.
Methods for determining
In ophthalmology, several methods for determining IOP are used, among which palpation and instrumental methods are distinguished. They, in turn, are subdivided into several more methods.
Contact methods
Contact techniques are called so because there is a touch to the cornea of the eye. They can be used by almost everyone, except for people with inflammation and in the postoperative period (after an operation on the eyes).
Maklakov method
The applanation technique according to Maklakov is carried out using a special tonometer that can determine the density of the eye due to the presence of small weights. Before the procedure, anesthetic drops are used, and the patient is in a horizontal position with a raised arm.
Then, in turn, intensely colored weights are placed on each eyeball, which are then transferred to paper and the diameter of the imprint is measured. Based on the figure obtained, the specialist can draw a conclusion about the intraocular pressure.
The disadvantage of the method is the measurement of not real pressure, but tonometric pressure, since when a weight is installed, a certain amount of liquid is poured out of the eye chambers.
With the applanation technique, it is possible that the norm is set within 12-25 mm Hg.
Schiotz and his method for measuring ophthalmotonus
The Schiotz method is as follows: in order to measure intraocular pressure, it is necessary to press on the cornea with a rod of a certain mass. Previously, drops for anesthesia are instilled into the conjunctival sac.
REFERENCE! This method underlies the impression tonometer.
On the rod is a small weight, which moves freely under the action of intraocular pressure. As a result, the arrow located on the device deviates and is fixed at a certain scale indicator. Further, the resulting figure is compared with tabular values created taking into account the weight of the weights.
To date, the impression type of measurement is considered the most reliable and accurate.
Dynamic IOP measurement
Dynamic measurement of IOP is carried out using the Pascal tonometer. This device is attached to the lamp, and its tip has a concave shape, i.e. almost repeats the real shape of the cornea and does not flatten it. Within a few seconds, the device captures a series of data, after which it independently calculates the average value, which becomes an indicator of IOP.
This method has no contraindications and can be performed with any features of the eye.
Useful video
Measurement of intraocular pressure (IOP):
Pneumotonometry
Pneumatic tonometry (pneumotonometry) is the easiest and fastest way to measure intraocular pressure. The patient is in a sitting position, and the doctor directs compressed air to the surface of the eyeball.
Under the influence of air flow, the membranes of the eye are deformed, and the tonometer records these changes.
Rebound tonometry
The advantage of the method is the ability to diagnose many ophthalmic diseases at an early stage. The tonometer is equipped with disposable tips, which are located at a distance of 3-10 mm from the center of the eye.
Then the doctor turns on the device, and the tip sharply and very quickly touches the shell of the eye and immediately bounces off it. The device records what the speed was and how long it took, after which the IOP indicator is calculated.
Contactless methods
Non-contact measurement of intraocular pressure is more comfortable for patients, but the methods give less accurate results. For this reason, they are used only in childhood or in the presence of diseases of the cornea.
With non-contact diagnostics, anesthesia is not required and the likelihood of infection is reduced to zero.
Air flow
The airflow method is used with different types of tonometers. The patient sits in front of the device, concentrates his gaze on the contact point, and the device supplies air flow to the center of the cornea.
REFERENCE! With this method it is advisable only to detect elevated intraocular pressure.
The method of optical coherence tomography is used to study eye tissues and diagnose ophthalmic pathologies in the early stages. The measurement process is carried out by directing an infrared stream to the patient's eye.
The pattern that appears on the shell of the eye can tell the specialist about the existing pathologies. Coherence tomography is prescribed for suspected glaucoma, optic nerve atrophy, and others at any stage.
Transpalpebral tonometry
One of the most convenient measurement methods, which is often assigned to children. Its feature is diagnostics with the eye closed using the Diaton device.
Advantages of transpalpebral tonometry:
- no contact with the cornea;
- infection is excluded;
- anesthesia is not required;
- the likelihood of complications is reduced to zero;
- carried out in any position of the patient.
Norm and deviations
The norm indicators may differ in different clinics, as they depend on the parameters of the measuring device. Usually, a segment of 10-23 mm Hg is taken as the norm, however, with some methods (for example, Maklakov), an indicator of 25 mm Hg. not considered a deviation.
REFERENCE! The average value of IOP is 14-16 mm Hg.
If the score is less than 13 and greater than 17, but is still within the normal range, the patient is recommended to have regular examinations, since these people are considered to be at higher risk.
Elevated IOP starts from 23 mm Hg. In this case, diagnostics are assigned, which will allow to find out the reason for the change in the indicator.
In the cold season and in the morning, the indicator can be 2-6 mm higher than the norm, in the evening and in the heat - lower.
Price
The cost of the study depends on many factors: the presence or absence of a referral, the pricing policy of the clinic, the method and device used. When diagnosing at a polyclinic at the place of residence, intraocular pressure is measured free of charge.
On average, the cost of measuring the IOP of one eye ranges from 200 to 400 rubles.
Conclusion
Diagnosis of almost no ophthalmic disease is not complete without measuring intraocular pressure. The blood supply and nutrition of the eye, which are responsible for metabolic processes and the normal functioning of the organ of vision, depend on IOP deviations. People over 40 years of age with a history of endocrinological or cardiovascular diseases are recommended to be screened every year.
Ekaterina Belykh
Internet journalist, translator
Articles written
If you find an error, please highlight a piece of text and click Ctrl+Enter.
The concept of “intraocular pressure”, which implies an increase or decrease in the pressure of the liquid contents of the eyeball on the sclera and cornea of the eye, is often encountered by ophthalmologists. An increase or decrease in this indicator is a deviation from the norm, which entails a deterioration in the quality of vision.
Intraocular pressure has a certain fixed value, due to which the normal shape of the eyeball is maintained, normal vision is ensured. It is worth figuring out what the pressure inside the eye depends on, how it is measured, what medicines and other ways to lower these indicators are.
Causes
Intraocular pressure is provided by the difference in the rate of addition and decrease of moisture in the chambers of the eye. The first ensures the secretion of moisture by the processes of the ciliary body, the second is regulated by the resistance in the outflow system - the trabecular network in the corner of the anterior chamber. Normal pressure maintains the general tone of the eye, helps to maintain its spherical shape. Consider the main reasons for the occurrence of IOP.
Causes of increased intraocular pressure
Various factors can provoke temporary or permanent increased pressure inside the eye. The reason for the constant increase is usually glaucoma, which in turn can develop under the influence of:
- vegetative-vascular dystonia;
- psycho-emotional stress, chronic stress;
- diseases of the heart and blood vessels,
- kidney disease,
- inflammatory process localized in the organ of vision;
- diencephalic pathology;
- traumatic brain injury;
- diabetes;
- constant intense load on the eyes, which can manifest itself when constantly sitting at a computer, working with papers, due to many other factors.
All of the above causes contribute to the periodic appearance of increased intraocular pressure. If the disease proceeds long enough, it can contribute to the development of glaucoma.
Increased intraocular pressure is often a sign of glaucoma, the risk of which increases markedly in adults after 40 years of age.
Low IOP: main causes
Low IOP, although rare, is no less dangerous. Factors contributing to the reduction of intraocular pressure are not as diverse as the prerequisites that increase it. These include:
- Injury to the organs of vision in the past;
- Purulent infections;
- Diabetes;
- Dehydration
- arterial hypotension;
- Alcoholic drinks and drugs (marijuana);
- Glycerin (when ingested).
If the reduced IOP lasts for more than a month, the nutrition of the structures of the eye is disrupted, and as a result, the eye may die.
Ophthalmotonus of an adult should normally not go beyond 10-23 mm Hg. Art. This level of pressure allows you to save microcirculation and metabolic processes in the eyes, and also maintains the normal optical properties of the retina.
Types of increased intraocular pressure
- Stable increase in IOP. In this case, the pressure inside the eye always exceeds the permissible limits, that is, it is a clear sign of glaucoma;
- Transient Boost. This condition is characterized by short-term single deviations from the norm. Occurs after a jump in blood pressure, and can also increase due to fatigue, prolonged work with a computer;
- labile increase. Increases periodically, but then returns to normal levels.
Experts recommend that after 40 years it is necessary to check the indicator in question in order to identify possible ailments in the future. A conscientious attitude to your health will help reduce the chances of developing eye diseases.
Symptoms
Intraocular pressure can manifest itself in a number of pathological disorders, consider all the symptoms in the table below.
Symptoms | |
Increased intraocular pressure | The most characteristic signs of an increase in intraocular pressure resulting from a violation of the circulation of aqueous humor are:
|
Decreased IOP | Frequent signs of the disease:
But most often, in the case of a gradual and prolonged decrease, there are no symptoms at all. Sometimes the presence of hypotension may indicate a deterioration in vision in general. |
Complications
Complications of increased internal eye pressure are quite severe:
- glaucoma,
- optic atrophy,
- retinal disinsertion.
These pathologies can lead to a significant decrease in vision and blindness.
Diagnostics
Measuring intraocular pressure is one of the ways to diagnose eye health, used in ophthalmology. The disease is diagnosed by ophthalmologists using special devices:
- Maklakov's tonometer;
- electrotonography;
- pneumotonometer.
In addition, the therapist can send the patient to narrow specialists: a cardiologist, a neurologist, etc.
The fight against increased intraocular pressure is the key task of confronting glaucoma, otherwise if the indicators are not stabilized in a timely manner, then the person is threatened with irreversible loss of vision.
Norm of intraocular pressure
The norm in an adult is considered to be in the range of 10 - 22 millimeters of mercury. If the indicator is constantly overestimated, we can talk about the development of glaucoma. At the same time, intraocular pressure usually does not increase with age, it can increase by only a couple of points.
Table with normal values and deviations
It is worth noting that IOP, regardless of the type, may be unstable or change during the day. The norm indicator can fluctuate within 2-2.5 mm. rt. Art.
Indicators can deviate both up and down. That is, both an increase and a decrease are possible. Both of these conditions are not normal and do not develop spontaneously. Usually, certain problems, negative factors or pathologies lead to changes in the volume or composition of intraocular contents.
Measurement of intraocular pressure in adults
In healthcare settings, doctors use proven methods to get the right results. These include tonometry according to Maklakov and Goldman. These are effective methods that have been used for many years.
Measurement of intraocular pressure: | Description of the procedure |
according to Maklakov | The essence of the procedure is that a weight moistened with paint is placed on the eye. After that, an imprint is made on the paper and special measurements are taken. The higher the IOP, the less ink is washed off the plates. This is due to the fact that the cornea flattens quite a bit under the weight of the weights. Therefore, contact with the surface of the convex part of the eye is minimal. |
according to Goldman | In modern ophthalmology, a non-contact Goldman tonometer is more often used to measure indicators. With this type of pressure level determination, the norm is approximately 11-13 mm Hg. The Goldman tonometer releases a certain volume of air at a given pressure. Using a special sensor, the device reads the tension of the cornea, which changes shape under the influence of the air flow. After that, the level of intraocular pressure is calculated. The device of the Goldman tonometer is complex, so you cannot use this device yourself. |
How is intraocular pressure measured without the help of devices?
Of course, this technique allows you to assess the condition of the eye very approximately, but still doctors advise everyone to master it. Palpation of the eyeball is carried out through closed eyelids with one finger. In order to evaluate the result, you need to apply a little pressure. Normally, the finger should feel an elastic ball, which is slightly pressed through.
IOP measurement result:
- If the eye is hard, like a stone, and does not deform at all when pressed, then there is a high probability that intraocular pressure is increased.
- If it is generally impossible to feel the spherical shape, and the finger easily "falls" into the eye, then this indicates a strong decrease in intraocular pressure.
According to medical recommendations, each person should visit an ophthalmologist's office at least once a year. In the event that discomfort occurs in the eyes or the quality of vision deteriorates, it is necessary to visit an ophthalmologist's office unscheduled. Many serious illnesses can be prevented if the cause that changes the pressure is diagnosed in a timely manner and appropriate treatment is initiated.
Treatment
Treatment of intraocular pressure depends on the causes that provoked it. If the cause is a certain disease, then only with its complete cure can eye pressure be brought back to normal. If the cause was any eye pathology, then the ophthalmologist will deal with the treatment, prescribing the necessary eye drops.
Increased intraocular pressure is treated using conservative techniques. Let's list them:
- Drops aimed at nourishing tissue cells and draining fluid.
- Treatment of the underlying disease if elevated IOP is a symptom of a systematic nature.
- The laser is used when medical methods are ineffective.
- Surgical intervention (microsurgery).
Drops for intraocular pressure
With an increase in pressure, a specialist usually prescribes drops that have a positive effect on the process of nourishing eye tissues or the outflow of intraocular fluids. If the cause of the increase in pressure is any third-party disease, then the doctor will take all measures to treat this disease.
The following types of drops are used to regulate IOP indicators:
- Xalatan affect pressure reduction by regulating outflow; liquids. Apply 1 time per day, preferably at night;
- Travatan regulates the outflow of water in the lens area and prevents the occurrence of glaucoma;
- Betoptik. The use of these drops restores and reduces the formation of intraocular fluid, thereby normalizing hypertension. It is recommended to use regularly, passing the course of treatment to the end, use twice a day, one drop in each eye;
- Timolol reduces the production of eye fluid and normalizes blood pressure.
Certain eye drops may cause a number of side effects, which are expressed as:
- burning sensation;
- eye redness;
- development of arrhythmia;
- increased heart rate;
- headaches.
If you experience unpleasant symptoms, you need to contact your doctor and replace the drug.
Physiotherapy procedures
The use of physiotherapy procedures is also indicated by appointment of a specialist. Their use contributes to the preservation of visual functions in cases of glaucoma, they are affected by color pulse therapy, phonophoresis, vacuum massage and infrasound. The portable eye device "Sidorenko Glasses" is widely used, which can be successfully used at home, including for children from the age of three.
Surgery (microsurgery)
The most radical method of treating intraocular pressure is microsurgical technologies: goniotomy with or without goniopuncture, as well as trabeculotomy. During goniotomy, the iridocorneal angle of the anterior chamber of the eye is dissected. Trabeculotomy, in turn, is a dissection of the trabcular mesh of the eye - the tissue connecting the ciliary edge of the iris with the posterior plane of the cornea.
Nutrition
If possible, we remove sugar, salt, minimize fast carbohydrates and animal fats. If you are obese, you need to lose weight. We strictly monitor the calorie content, eat often and in small portions.
And what products must be:
- Berries;
- Red vegetables and fruits.
- Meat, especially red and lean;
- Fish;
- Nuts;
- Vegetable oils;
- Bitter chocolate (the darker the better)
- Spices (sage, turmeric, mint).
To maintain and restore cells and tissues of the eye and the whole body, vitamins must first be included in the diet. Among all groups of vitamins, vitamins A (beta-carotene), E and C are the most important. They have high antioxidant properties, largely preventing the progression of the disease.
Take vitamin-mineral eye complexes and similar products:
- Fish oil and unsaturated fatty acids in general;
- Vitamins A, C, E and group B;
- Trace elements magnesium, phosphorus, zinc;
- Amino acids, especially L-carnitine and melatonin.
Prevention
Preventive measures:
- give up excessive smoking and drinking alcohol, as well as salt;
- use a balanced diet, avoid cholesterol-containing foods;
- do physical education;
- provide yourself with a good rest;
- walk more often in the fresh air;
- avoid stressful situations;
- replace tea and coffee with fruit drinks, juices and herbal drinks;
- perform a light massage near the eyeballs and special exercises for the eyes;
- control the time spent at the computer or near the TV, in the process of reading, knitting, beadwork, embroidery and other activities that require eye strain.
So, we found out that intraocular pressure must be maintained at a normal level. Otherwise, an insidious and dangerous disease, glaucoma, can develop, which can lead to complete loss of vision. It is possible to prevent the development of various eye diseases, including blindness, only with a timely visit to a doctor. If there is the slightest discomfort and deviations in the functionality of the eye, it is necessary to contact an ophthalmologist.
And burning eyes. This condition is often a sign of increased eye pressure, which leads to various ophthalmic diseases.
For this reason, it is important to identify alarming symptoms in time, and the treatment of pathology in adults will not require much effort.
What it is
Every second, a certain amount of fluid enters the organs of vision, then it flows out. Disruption of this process causes the accumulation of moisture, which causes high eye pressure.
At the same time, small vessels that regulate the outflow of fluid are deformed, and nutrients cease to flow into all parts of the eye, causing cell destruction.
This happens under the influence of many factors, including:
- heavy eye strain (poor lighting in the room, watching TV);
- genetic predisposition;
- internal organs and eyes;
- chemical poisoning;
- hormonal disbalance;
- bad ecology;
- the use of certain b and medicines;
- damage to the integrity of the membranes of the eye;
- stressful state;
- disruption of the heart and blood vessels.
Changes in eye pressure are equally common in both sexes. Its increase is observed mainly in people after 40 years.
A neglected pathology can lead to the development of diseases that modern medicine is not always able to overcome. Today, more than five million people in the world are blind due to high eye pressure.
Norm of eye pressure in adults
Eye pressure is measured in millimeters of mercury. Please note that this figure may vary depending on the time of day. In the evening it is usually lower than in the morning.
Sometimes high blood pressure is an individual feature of a person and is not considered a pathology.
- In men and women aged 30-40 years old the norm varies from 9 to 21 mm Hg. Art.
- With age, the risk of developing ophthalmic diseases increases, therefore after 50 years it is important to regularly undergo an examination of the fundus of the eyes, measure pressure and take tests.
- Norm at 60 slightly higher than at younger ages. Its indicators can reach up to 26 mm Hg. Art. when measured with a Maklakov tonometer.
- Aged 70 years old and older, the norm is considered to be from 23 to 26 mm Hg.
How to measure
In the detection and treatment of eye diseases, ultra-precise pressure measurements are important, because even a slight discrepancy in the indicators can lead to serious consequences.
There are several ways to determine eye pressure in a hospital setting.
Depending on the principle of influence, they are contact And contactless .
In the first case, the eye surface is in contact with the measuring device, in the second case it is not.
Ophthalmologists use one of the methods:
- Pneumotonometry . Pressure measurement with an air jet.
- Electronograph . A modern way to measure IOP. It is safe and painless, based on increased fluid production inside the eye.
- Tonometry according to Maklakov . It is performed under local anesthesia and causes little discomfort.
It is impossible to independently identify pathology at home.
In people who suffer from glaucoma or other eye diseases, the pressure of the organs of vision is measured regularly. Sometimes they are prescribed daily tonometry, which is carried out for 7-10 days three times a day. All indicators are recorded, and as a result, the specialist displays the maximum and minimum values.
Symptoms and signs of high IOP
Usually a slight increase in eye pressure does not show itself in any way, and the person does not notice the changes. Symptoms of pathology appear depending on the severity of the disease.
For a progressive disease, certain signs are characteristic:
- Increased eye fatigue.
- Pain in the head in the temples or forehead.
- Discomfort when moving the eyeballs.
- White redness.
- Arcs and before the eyes in the light.
- Bad twilight vision.
- Heaviness, dry eyes.
- Visual impairment.
In the case of greatly increased pressure, a person can no longer perform his usual work, it is difficult for him to read text with small print. With an infection or inflammatory process, the patient has a sinking of the eyeballs, lack of luster.
How to reduce pressure in the eyes?
Only significant fluctuations in ophthalmotonus, which affect visual acuity, need treatment.
To treat high IOP, the doctor usually prescribes pills and drops for eye pressure. They reduce the production of intraocular fluid, open additional ways for its outflow. It is important to identify the cause of the pathology and direct treatment to eliminate the underlying problem.
Today, the following drugs are popular to help relieve eye pressure:
- Timolol.
Treatment non-traditional methods should be agreed with the attending physician, because only he knows how to treat the pathology in a particular case. These methods are effective only at the initial stage of the disease. In case of advanced disease, surgical intervention will be required.
With increased IOP, it is necessary to observe preventive measures, namely:
- It is advised to sleep on a high pillow, which should not be very soft.
- It is necessary to reduce the amount of alcohol consumed, quit smoking.
- It is recommended to give up sweet and flour products, potatoes, pasta and cereals. It is worth increasing the amount of black berries in your diet.
- Once every six months you need to visit an ophthalmologist.
- It is necessary to walk more often in the fresh air, lead an active lifestyle and get enough sleep.
- You need to do gymnastics for the eyes daily, as well as use special drops that moisturize them.
Do not attribute eye fatigue to ordinary lack of sleep, because such a problem can provoke the development of a dangerous pathology and cause blindness. At the first sign of increased eye pressure, you should consult an ophthalmologist. It is much easier to treat it at the initial stage.
Video:
Pressing headache in the area of the eyes and temples is a frequent companion of office workers. During the next attack, it is difficult for them to read, especially if the text is written in small print, and in general, any attempts to focus their eyesight on a flickering monitor screen seem unbearable. It is easiest to explain this state by banal fatigue, but not everything is as simple as it seems at first glance. The reason may be increased intraocular pressure, and if this diagnosis is confirmed at an ophthalmologist's appointment, then neither rest nor the problem will be solved. You need to take measures and drops, and do it as soon as possible - the risk of developing glaucoma at this stage is already very high.
The structure of the eye has a complex structure, but it is not necessary to study it all in detail in order to understand what intraocular pressure is and why it suddenly deviates from the norm. It is enough to imagine the eye as a liquid surrounded by multiple shells. Outer - the sclera, behind it - a network of blood vessels, even deeper - the ciliary body. When his muscles contract, the shape of the lens changes and the person can view something up close. But this is not the only function of the ciliary body.
Another important task that is entrusted to him is the secretion of intraocular fluid. Circulating between the different chambers of the eye, it ensures normal metabolism and maintains a certain level of intraocular pressure (IOP). In other words, the fluid secreted by the ciliary body constantly presses on the eye, setting the parameters for its normal size and shape. As soon as the amount of this fluid increases excessively or there are problems with its outflow, the pressure will jump. This will entail a distortion of the shape, and, consequently, of the entire optical system of the eye.
Important! Intraocular pressure directly affects the quality and visual acuity. When it deviates from the norm, the shape of the eyeball changes and accommodation mechanisms are disrupted, allowing you to see near.
Norm of pressure and pathology
Intraocular pressure may fluctuate slightly, depending on what time of day the study is performed, but in general it is a constant value. In the morning, intraocular pressure can jump by 2-3 marks. Most likely, the reason lies in the horizontal position of the body, the slowing of the pulse and breathing, as well as the predominance of the parasympathetic nervous system during sleep. By evening, the pressure gradually drops.
The normal intraocular pressure is between 10 and 21 mm. rt. column, although much here depends on how to measure. These figures are the limit of true pressure, but if you try to determine it tonometrically, then the norm will be different - from 12 to 25 mm. rt. Art. That is, it is simply not correct to compare indicators obtained in different ways.
Important! In domestic ophthalmological clinics, the method of the Russian researcher Maklakov is used to measure intraocular pressure. According to him, normal intraocular pressure is that which is below 26 mm Hg, from 27 to 32 mm Hg. Art. - moderately elevated, more than 33 mm Hg. reason to take action.
Measurement according to Maklakov
- The patient lies down on the couch, and the doctor administers anesthesia by instilling a few drops of dicain into each eye alternately.
- Then the head is fixed and asked to look at one point.
- A small weight, treated with a special marking paint, is carefully lowered onto the open eye, under the pressure of which the eyeball should be slightly deformed.
- Now the load is lowered onto a sheet of paper to see how much paint is left on it. The indicator of intraocular pressure is determined by the intensity of the imprint.
- The procedure is repeated once more on both eyes to avoid the possibility of erroneous interpretation.
Naturally, a certain amount of paint from the load will remain on the surface of the eyeball, but it will quickly be washed off with a tear. Instead of weights, ophthalmologists sometimes use a portable device that looks like a ballpoint pen. They are also pressed on the eye, having previously treated the eyeball with an anesthetic.
This method has an alternative -. No weights are placed on the eye, but instead a controlled airflow is used. For many patients, this method seems more acceptable, but in reality it is rarely used - it is not so accurate.
Important! In patients with glaucoma, eye pressure during the day fluctuates much more noticeably than in healthy people. Having such suspicions, the doctor may ask the patient to come to the clinic several times during the day. To verify the accuracy of the diagnosis, you need to measure the pressure at least three times before lunch, and the same number in the evening.
How to measure the pressure inside the eye yourself?
Without the help of a doctor and special equipment, it is impossible to determine with what force the fluid secreted by the ciliary body presses on the eye. Nevertheless, it is possible to understand that the pressure is greatly increased and ophthalmologists recommend that everyone master this simple technique.
Close your eyes and relax. Now gently press your index finger on the eyeball. You should feel an elastic ball that gives in to your pressure - this is the norm. If the eye is very hard and practically does not deform - most likely, the IOP level is elevated and it is better to contact a specialist to make sure that its value is not critical.
5 main symptoms of intraocular pressure
At first, the syndrome of increased IOP does not manifest itself in some special way. From time to time, headaches and eye fatigue may occur, especially when you are in front of a monitor or in a room with poor lighting. But there are no serious problems with vision yet.
Over time, when chronically elevated eye pressure becomes a symptom of the early stages of glaucoma, the patient complains of:
- frequent migraines and severe pain in the eyes;
- general deterioration of vision;
- "flies" and rainbow circles before the eyes;
- almost complete blindness in the dark and twilight;
- a significant narrowing of the visual fields - it is no longer possible to look at something from the side "out of the corner of the eye", each time you need to turn your head and strain your eyes.
Important! With glaucoma, acute attacks are possible, when the pressure jumps sharply up to 60-70 mm Hg. Art. This condition is accompanied not only by complete clouding in the eyes, but also by a general malaise - dizziness, nausea, and vomiting may begin. In this case, the sooner the ambulance arrives, the higher the chances of saving not only vision, but also the patient's life.
Why does intraocular pressure increase?
Two links are responsible for the regulation of intraocular pressure - the nervous system and some hormones. That is why most often a temporary increase in IOP is associated with increased mental work, stress and the experience of violent emotions. In women, the risk of glaucoma can develop during menopause, when large-scale hormonal changes take place in the body.
So, the true cause of IOP most often needs to be sought in one of the following areas.
- Chronic stressful situations, prolonged mental or physical stress.
- Problems with the cardiovascular system that provoke jumps in blood pressure.
- Some kidney diseases, due to which a lot of fluid is retained in the body.
- Endocrine pathologies, in particular, an increased content of adrenal hormones in the blood, hypothyroidism.
- Anatomical pathology in the structure of the eyeball. Especially careful in this regard should be people suffering from atherosclerosis.
In any case, it is important to understand that intraocular pressure does not suddenly increase by itself, it is always a consequence. Sometimes - hidden pathological processes occurring in the body, and sometimes - diseases associated directly with the eyes. So, to provoke a jump in IOP can:
- an eye tumor that presses on the inner membranes and chambers of the eye, thereby interfering with the normal outflow of fluid;
- inflammatory disease of the iris (iritis), ciliary body (cyclitis), choroid ();
- a severe injury to the eye, after which inflammation, swelling and stagnation of blood in the vessels inevitably appear.
Important! Under any of the above circumstances, IOP cannot be critically high all the time. It rises periodically, in leaps, which depend on the characteristics of the course of the disease that provokes it. But if the pathology is not found and cured, then with age, increased IOP can transform into glaucoma. Gradually, due to strong pressure, the cells of the retina will be destroyed, the optic nerve will atrophy, and in the end the person will completely lose sight.
How to relieve intraocular pressure?
Trying to deal with the consequences without eliminating the cause is useless. That is why, noticing that your eyes are constantly tired, reddened and very tense, you need to look for a reason that provokes periodic jumps in intraocular pressure. Further, the method of restoring the eyes will depend on how neglected everything is.
If we are talking about the initial stages and barely noticeable symptoms, then, most likely, only preventive measures will be enough:
- master a set of exercises for the eyes and give it a few minutes a day;
- pick up protective glasses for reading and being in front of the monitor;
- as far as possible, limit any eye loads - TV, computer, work with small details;
- give up contact and power sports;
- free time to spend in the air, allowing the eyes to relax and look into the distance.
Treatment of intraocular pressure with drops
When high IOP ceases to be episodic and develops into ocular hypertension or hypotension, preventive measures alone are not enough - timely local treatment is needed. With such diagnoses, the pressure in the eye is easiest to adjust with eye drops. They are of several types.
- Those that act directly on the ciliary body and reduce fluid production are carbonic anhydrase inhibitors. The most popular of this group are "Azopt" and "". By reducing the amount of intraocular fluid, pressure also decreases, but this process can be accompanied by burning, severe redness of the eyes, and even a bitter taste in the mouth.
- The second category is prostaglandins. They operate on a different principle: they do not affect the amount of liquid, but its intensive outflow. If this is the problem, most often appoint "", "Taflotan" and "". But they also have side effects - the iris of the eye may darken.
- Beta blockers - for example, Timolol, Okumol, Okupress, Arutimol, Okumed and the more modern Betoptik. They also reduce the amount of fluid formed in the eye, but they have one significant nuance - together with eye pressure, they reduce the heart rate, which is categorically contraindicated for cores.
There are also combined drugs that act in two directions: on the one hand, they inhibit the process of fluid production, and on the other, they increase its outflow. This category includes Xalakom, Fotil, Kosopt.
Important! On average, drops are used twice a day, but only a doctor can determine the exact dosage and frequency of instillation, having an accurate description of the clinical picture in his hands. By self-medicating, you can not only damage your eyesight even more, but also deal a blow to the cardiovascular system, lungs and kidneys.
Removal of intraocular pressure at home
If you feel pressure in your eyes, but you cannot immediately get an appointment with an ophthalmologist, then instead of drops, you can try to relieve painful symptoms with folk methods. Helps to normalize eye pressure:
- a decoction of meadow clover (brew with boiling water, leave for 2 hours and drink 100 g before bedtime);
- golden mustache tincture (pour about 20 purple inflorescences with 500 grams of vodka and leave in a dark place for 12 days, then take one teaspoon before breakfast);
- a glass of kefir with cinnamon.
No matter how tempting such treatment may seem, ophthalmologists do not recommend relying too much on it. Such recipes can be used only if the pressure jumps rarely and not much. Trying to get rid of serious symptoms in this way, indicating progressive blindness, is simply dangerous.
Most of these arrogant patients, when they finally get to the ophthalmologist's office, hear one thing: "an operation is needed." A laser is used to relieve high intraocular pressure. Depending on where the problem is concentrated, they can either excise the iris or stretch the trabecula to increase the outflow of fluid.
If you do not want to get into the operating room, take the advice of ophthalmologists seriously and constantly engage in prevention. A five-minute break every hour of work near the computer, the simplest set of gymnastic exercises for the eyes, a dinner of sea fish and blueberry-carrot snacks - and you will maintain sharp eyesight for many years!
The human eye is a dynamic structure, the amount of fluid in which is constantly changing. Due to internal secretion, it increases, and due to natural outflow, it decreases. The process of such an exchange forms intraocular pressure. How is intraocular pressure measured and why do you need to know it?
Changes caused by increased or decreased eye pressure may remain invisible for a long time. The symptoms that appear - a headache or redness of the eyes, people attribute to fatigue and do not pay attention. Therefore, most often measurements of eye pressure are carried out in such cases:
- Screening for glaucoma. Eye pressure is measured in people who are at risk of the disease - in those over 40 years of age, or with a genetic predisposition. You need to get tested regularly. For greater reliability, it is better to use the same measurement method each time.
- When symptoms associated with fluctuations in IOP appear. This may be a decrease in visual functions, in this case, flies and turbidity may occur in the field of view. Pain is felt in the eyes and temporal part of the head, the eyeball turns red.
Important! Increased or decreased eye pressure is a symptom of injuries of the eyeball or its diseases - tumor processes and inflammation (iritis, iridocyclitis, uveitis). These diseases are dangerous, so it is important to diagnose them in time.
Increased and decreased IOP has unpleasant consequences for the body. Thus, increased eye pressure leads to atrophy of retinal cells and disruption of metabolic processes in the eyeball. Glaucoma is also a common consequence of increased eye pressure.
Low eye pressure is no less dangerous. Hypotension of the eye leads to the expansion of intraocular vessels and, as a result, to venous congestion. Because of this, metabolic processes inside the eye are disrupted and degenerative changes begin. Also often there is clouding of the cornea and vitreous body, retinal atrophy. Due to the low pressure, the eye is gradually reduced and vision is reduced.
Important! Both low and high eye pressure without proper treatment can lead to complete blindness.
IOP is measured in millimeters of mercury, although many countries have begun to switch to SI units expressed in hexa- or kilopascals (hPa and kPa, respectively). Measurements can be either direct, when a special manometer is inserted into the eye, or indirect.
The second method is not so accurate, as it affects the hydrodynamics of the eye, especially in the case of the Maklakov tonometer. Therefore, true and tonometric pressure are distinguished, the indicators of which have significant differences. So, the norm of true pressure is from 10 to 21 mm. mercury column, and tonometric - from 12 to 25.
It is impossible to equate to each other the indications of true and tonometric pressure. A normal tonometric indicator (for example, 24 mm Hg) is elevated for true.
Eye pressure standards
In adult healthy men and women, the level of IOP is practically the same - on average, female indicators are only 0.5 mm higher. rt. Art. Starting from the age of 20, they begin to rise, so after 65 years, higher pressure can be considered the norm.
The situation is different in infants - there are very few reliable studies on their intraocular pressure and scientists have not yet come to final conclusions.
The table shows the pressure norms for different age groups.
Important! The IOP parameters of both eyes should be similar. If there is a difference of 4-5 mm between measurements. rt. Art., you should be careful and get checked for glaucoma.
With an increase in intraocular pressure, glaucoma can occur, the severity of which depends on how much the norm is exceeded.
Pressure changes in glaucoma.
Stage of the disease | Tonometric pressure according to Maklakov, mm. rt. Art. | True pressure measured in a non-contact way, mm. rt. Art. |
---|---|---|
Norm | 12-25 | 10-21 |
Initial glaucoma | up to 26 | 21-22 |
Moderate | Up to 36 | up to 26 |
Third stage | — | up to 33 |
terminal stage | — | 35 or more |
This table refers to adults, for children and the elderly, appropriate recalculations are made.
Research methods
There are several basic measurement methods, depending on the instrument used for this:
- The direct method is carried out using a pressure gauge and is practically not used now.
- Indirect methods can be both contact and non-contact, such as pneumotonometers. Most often, eye pressure is measured by contact, using a Maklakov tonometer.
Maklakov's tonometer
It is a set consisting of two ten-gram tonometers, a holder and a measuring ruler.
It is designed to determine the intraocular pressure by the applanation method, in which the cornea is flattened with a flat weight of constant weight. An imprint of the cornea remains on the weight, by measuring which the IOP is determined.
Preparation for work consists in thorough disinfection of the surface of the tonometer and application of a special dye to its surface. Local anesthesia is applied to the cornea - 0.1% dicaine solution is dripped into the eye. After that, excess tears are removed from the conjunctival sac of the tonometric eye with a gauze ball.
Important! The conjunctival surfaces and rims of the eyelids must be completely separated from the surface of the eyeball so as not to put pressure on it. The doctor's fingers, opening the palpebral fissure, should be located outside the orbit, leaning on the bony edges of the orbit.
During the measurement, the patient should look straight up. The doctor places a tonometer over his eye and does not start the measurement until he is sure that the weight is located exactly above the patient's limb. The tonometer is slowly lowered until it touches the eye, and left in this position for 1.5-2 seconds. After that, the weight is removed and a disinfectant solution is instilled into the eye.
The tonometer is pressed against a tonometric form - a piece of non-glossy paper moistened with an alcohol solution. A tonogram remains on the form - a clear round imprint.
Important! Only tonograms with clear contours should be measured. Their shape may also be oval.
The ruler is placed on top of the form and placed so that it fits clearly between the boundary lines. According to the divisions plotted on the line, the level of IOP is recognized.
The main advantage of the Maklakov tonometer is accurate, albeit overestimated, results. But the device also has a minus - the porcelain or glass parts of the device often fail, and are also poorly sterilized.
Pneumotonometer HNT-7000
Pneumotonometers are non-contact meters, which is why they have significant advantages over contact ones - they do not require local anesthesia and do not contribute to the spread of infections. The HNT-7000 pneumotonometer is equipped on one side with instruments for examination and restrictive arms for the patient's face, and on the opposite side - with a rotary touch screen for settings. After the measurement, the results are displayed on the screen.
The pneumotonometer HNT-7000 automatically finds the human pupil and sends a short air stream lasting 3 ms to the cornea. (blinking lasts 10 ms). Electronic devices determine the degree of resistance of the cornea to the action of an air jet. The measurement results are displayed on the screen.
The main advantage of the device is that the patient is not afraid of mechanical impact on the cornea, is less nervous, so the result is not so distorted.
Electro tonograph GlauTest-60
The tonograph measures not only eye pressure, but also the parameters of hydro- and hemodynamics of the eye. Electrotonograph GlauTest-60 is often used for screening, as it is simple and easy to use. The device operates in fully automatic mode. The meter is mounted on a special movable stand, which allows you to adjust it to any patient.
The work uses an impression technique - the reaction of the cornea to a short-term force applied by a rod installed in a special sensor is measured. The device automatically determines the location of the patient's pupil and directs the rod to the center of the cornea. Measurement is taken in a sitting position.
The design of the sensor makes it easy to disassemble and assemble, which facilitates the disinfection of elements that come into contact with the eye.
At the moment, there are also the latest developments, for example, contact lenses for measuring IOP in real time. Devices improve every year, the measurement accuracy increases, which will allow avoiding many vision problems in the future.