Influence of Near Vision Tasks on Intraocular Pressure in Normal Subjects and Glaucoma Patients

Abstract

Purpose: To investigate the effect of static accommodative tasks on intraocular pressure (IOP) of glaucomatous and normal eyes.


Methods: Four groups of subjects categorized as primary open-angle glaucoma (POAG), primary angle-closure suspects (PACS), normal age-matched controls, and normal young adults (NYA; age <40 years) were enrolled. The baseline IOPs were measured after the subjects were looking at a distant target for 15 min. Static accommodation was obtained by execution of near vision tasks (reading at 33 cm in daylight [300 lux] for 60 min). IOPs were measured at 15, 30, 45, and 60 min intervals while accommodating and then measured again after 15 min of relaxing accommodation while looking at a distant target.


Results: One-hundred and eighteen eyes of 98 subjects were recruited. The study groups consisted of the following categories: 25 POAG (46 eyes), 24 PACS (47 eyes), 25 matched controls (50 eyes), and 24 NYA (48 eyes). Within all groups, the mean IOP decreased throughout the accommodation period at all time points. Maximum IOP reduction after accommodation was detected at the 30-min time among the POAG subjects, at the 45-min time in the PACS and matched control groups, and at 15 min after the relaxation of accommodation in the NYA group. IOP reduction levels showed no statistically significant difference among POAG, PACS, and the normal matched groups in their response to accommodation. However, NYA had significantly lower IOP and greater IOP reduction after the resting period (relaxation of accommodation).


Conclusion: Static accommodative tasks can significantly reduce IOP in normal, POAG, and PACS individuals. Encouraging glaucoma patients to practice periodical near vision tasks could be viewed as an adjunctive measure for glaucoma management.

Keywords:

Accommodation, Accommodative Tasks, Intraocular Pressure, Primary Openangle Glaucoma

References
1. Lütjen-Drecoll E. Functional morphology of the trabecular meshwork in primate eyes. Prog Retin Eye Res 1999;18:91–119.

2. Jenssen F, Krohn J. Effects of static accommodation versus repeated accommodation on intraocular pressure. J Glaucoma 2012;21:45–48.

3. Priluck AZ, Hoie AB, High RR, Gulati V, Ghate DA. Effect of near work on intraocular pressure in emmetropes. J Ophthalmol 2020;2020.

4. Johnstone MA. The aqueous outflow system as a mechanical pump: Evidence from examination of tissue and aqueous movement in human and non-human primates. J Glaucoma 2004;13:421–438.

5. Baser G, Karahan E, Bilgin S, Unsal U. Evaluation of the effect of daily activities on intraocular pressure in healthy people: Is the 20 mmHg border safe? Int Ophthalmol 2018;38:1963–1967.

6. Ha A, Kim YK, Park YJ, Jeoung JW, Park KH. Intraocular pressure change during reading or writing on smartphone. PloS One 2018;13.

7. Vera J, Redondo B, Molina R, Cárdenas D, Jiménez R. Acute intraocular pressure responses to reading: The influence of body position. J Glaucoma 2020;29:581–586.

8. Weinreb RN, Friedman DS. Angle closure and angle closure glaucoma: Reports and consensus statements of the 3rd global AIGS consensus meeting on angle closure Glaucoma. Kugler Publications; 2006.

9. Mauger RR, Likens CP, Applebaum M. Effects of accommodation and repeated applanation tonometry on intraocular pressure. Am J Optom Physiol Opt 1984;61:28–30.

10. Read SA, Collins MJ, Becker H, Cutting J, Ross D, Savill AK, et al. Changes in intraocular pressure and ocular pulse amplitude with accommodation. Br J Ophthalmol 2010;94:332–335.

11. Park CY, Lee JK, Kahook MY, Schultz JS, Zhang C, Chuck RS. Revisiting ciliary muscle tendons and their connections with the trabecular meshwork by two photon excitation microscopic imaging. Invest Ophthalmol Vis Sci 2016;57:1096–1105.

12. Barany E. The mode of action of miotics on outflow resistance. A study of pilocarpine in the vervet monkey Cercopithecus ethiops. Trans Ophthalmol Soc UK 1966;86:539–578.

13. Chowdhury UR, Hann CR, Stamer WD, Fautsch MP. Aqueous humor outflow: Dynamics and disease. Invest Ophthalmol Vis Sci 2015;56:2993–3003.

14. Armaly MF, Burian HM. Changes in the tonogram during accommodation. AMA Arch Ophthalmol 1958;60:60–69.

15. Armaly MF, Jepson NC. Accommodation and the dynamics of the steady-state intraocular pressure. Invest Ophthalmol Vis Sci 1962;1:480–483.

16. Cassidy L, Delaney Y, Fitzpatrick P, Blake J. Effect of accommodation on intraocular pressure in glaucomatous eyes. Irish J Med Sci 1998;167:17.

17. Abu-Hassan DW, Acott TS, Kelley MJ. The trabecular meshwork: A basic review of form and function. J Ocul Biol 2014;2.

18. Schachar RA. The mechanism of accommodation and presbyopia. Int Ophthalmol Clin 2006;46:39–61.

19. Wang K, Li G, Read AT, Navarro I, Mitra AK, Stamer WD, et al. The relationship between outflow resistance and trabecular meshwork stiffness in mice. Sci Rep 2018;8:1–12.

20. Yan L, Huibin L, Xuemin L. Accommodation-induced intraocular pressure changes in progressing myopes and emmetropes. Eye 2014;28:1334–1340.

21. Young FA. The development and control of myopia in human and subhuman primates. 1975.

22. Liu Y, Lv H, Jiang X, Hu X, Zhang M, Li X. Intraocular pressure changes during accommodation in progressing myopes, stable myopes and emmetropes. PloS One 2015;10.

23. Ha A, Kim YK, Kim J-S, Jeoung JW, Park KH. Changes in intraocular pressure during reading or writing on smartphones in patients with normal-tension glaucoma. Br J Ophthalmol 2019.

24. Cheng MA, Todorov A, Tempelhoff R, McHugh T, Crowder CM, Lauryssen C. The effect of prone positioning on intraocular pressure in anesthetized patients. Anesthesiology 2001;95:1351–1355.

25. Ozcan MS, Praetel C, Bhatti MT, Gravenstein N, Mahla ME, Seubert CN. The effect of body inclination during prone positioning on intraocular pressure in awake volunteers: A comparison of two operating tables. Anesth Analg 2004;99:1152–1158.

26. Najmanová E, Pluháček F, Haklová M. Intraocular pressure response affected by changing of sitting and supine positions. Acta Ophthalmol 2020;98:e368–372.

27. Mayalı H, Tekin B, Kayıkçıoğlu ÖR, Kurt E, İlker SS. Evaluation of the effect of body position on intraocular pressure measured with rebound tonometer. Turk J Ophthalmol 2019;49:6.

28. Uzlu D, Akyol N, Türk A, Gürsoy N, Somuncu AM, Oruç Y. Effect of body position on intraocular pressure measured by rebound tonometer in healthy children. Turk J Ophthalmol 2020;50:271–274.