title: Change in intraocular pressure during scleral depression.
abstract: OBJECTIVE
  Manometric studies have found that intraocular pressure (IOP) rises 116-350 mmHg during scleral depression in surgical settings. No information is available regarding the effect of scleral depression on IOP in routine clinical settings. The aim of this study is to quantify the change in IOP that occurs when scleral depression is performed on normal eyes in a routine clinical setting.
  
  
  METHODS
  A total of 28 eyes from 28 normal subjects were included. Tono-Pen tonometry was performed while scleral depression was performed in each of the two quadrants: superotemporal (ST) and inferonasal (IN). A post-procedure IOP measurement was obtained following each scleral depression examination. Both ST and IN quadrants were tested on all eyes, with the quadrant tested first chosen at random (15 ST, 13 IN).
  
  
  RESULTS
  The mean IOP during scleral depression was 65.3 mmHg ST and 47.8 mmHg IN, with a maximum recorded IOP of 88 mmHg. The mean change in IOP for the ST quadrant was 51.9 ± 17.3 mmHg and 46.4 ± 16.0 mmHg for the right and left eyes, respectively. The mean change in IOP for the IN quadrant was 45.3 ± 22.7 mmHg and 16.8 ± 15.8 mmHg for the right and left eyes, respectively.
  
  
  CONCLUSIONS
  Scleral depression as performed in a routine office setting produces wide fluctuations in IOP and may impair ocular perfusion. Additional studies are needed to determine the long-term consequences of routine scleral depression.
authors.affiliation: Rosenberg School of Optometry, University of the Incarnate Word, 9725 Datapoint Drive, San Antonio, TX 78229, United States. Electronic address: rctrevin@uiwtx.edu.
authors.forename: Richard
authors.initials: R
authors.lastname: Trevino
authors.affiliation: Rosenberg School of Optometry, University of the Incarnate Word, 9725 Datapoint Drive, San Antonio, TX 78229, United States.
authors.forename: Brandi
authors.initials: B
authors.lastname: Stewart
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D012590:Sclera / Q000601:surgery*; D014065:Tonometry, Ocular; D055815:Young Adult
keywords: Binocular indirect ophthalmoscopy; Depresión escleral; Intraocular pressure; Oftalmoscopia indirecta binocular; Presión intraocular; Scleral depression