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Concept
Intraocular pressure
Summary
Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated to measure pressure in millimeters of mercury (mmHg).
Intraocular pressure is determined by the production and drainage of aqueous humour by the ciliary body and its drainage via the trabecular meshwork and uveoscleral outflow. The reason for this is because the vitreous humour in the posterior segment has a relatively fixed volume and thus does not affect intraocular pressure regulation.
An important quantitative relationship (Goldmann's equation) is as follows:
Where:
is the IOP in millimeters of mercury (mmHg)
the rate of aqueous humour formation in microliters per minute (μL/min)
the resorption of aqueous humour through the uveoscleral route (μL/min)
is the facility of outflow in microliters per minute per millimeter of mercury (μL/min/mmHg)
the episcleral venous pressure in millimeters of mercury (mmHg).
The above factors are those that drive IOP.
Palpation is one of the oldest, simplest, and least expensive methods for approximate IOP measurement, however it is very inaccurate unless the pressure is very high. Intraocular pressure is measured with a tonometer as part of a comprehensive eye examination.
Measured values of intraocular pressure are influenced by corneal thickness and rigidity. As a result, some forms of refractive surgery (such as photorefractive keratectomy) can cause traditional intraocular pressure measurements to appear normal when in fact the pressure may be abnormally high. A newer transpalpebral and transscleral tonometry method is not influenced by corneal biomechanics and does not need to be adjusted for corneal irregularities as measurement is done over upper eyelid and sclera.
Current consensus among ophthalmologists and optometrists defines normal intraocular pressure as that between 10 mmHg and 20 mmHg. The average value of intraocular pressure is 15.
Official source
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