title: Intraocular pressure curves of untreated glaucoma suspects and glaucoma patients in sitting and lateral decubitus positions using the goldmann applanation tonometer.
abstract: OBJECTIVE
  Evaluation of data obtained during diurnal intraocular pressure (IOP) measurements by means of the Goldmann Applanation tonometer in sitting and lateral decubitus positions.
  
  
  METHODS
  Retrospective cohort study of 41 consecutive untreated subjects (82 eyes) with ocular hypertension or suspicious discs. The IOP was measured by Goldmann Applanation tonometer in sitting position at 9 AM, 12 AM, 3 PM, and 6 PM; and in right lateral decubitus position around 12:15 PM.
  
  
  RESULTS
  In the right eye (RE) mean peak IOP was 22.19±4.68 mm Hg. In the left eye (LE) peak mean IOP was 22.19±3.8 mm Hg. In 91.5% of the eyes, the IOP increased in the lateral decubitus position. The average change in the RE was an increment of 4.22±2.67 mm Hg (P<0.001) and in the LE an increment of 3.51±3.11 (P<0.001). This increment was significantly higher in the dependent eye (i.e., lower eye) (P=0.049). Sixty-seven percent of eyes had a positional elevation of IOP between 2 and 5 mm Hg and 23.2% of eyes had IOP elevation between 6 and 12 mm Hg. In the great majority of the eyes (80.5% RE and 78% LE) the lateral decubitus IOP was greater than maximal diurnal sitting IOP.
  
  
  CONCLUSIONS
  The IOP in the lateral decubitus position was significantly higher than the mean maximal diurnal sitting IOP. Over 20% of the patients had an IOP increase of ≥6 mm Hg when lying down. Timely identification of patients with excessive postural elevation of IOP could affect their management and prevent visual fields loss.
authors: *Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel †Private Glaucoma Clinic.
authors: Ilia
authors: I
authors: Piven
authors: Yoseph
authors: Y
authors: Glovinsky
mesh_terms: D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D012189:Retrospective Studies; D014065:Tonometry, Ocular / Q000295:instrumentation* / Q000379:methods*