Attempted eyelid cloure affect intraocular preure meaurement in open-angle glaucoma patient

PURPOE: To evaluate the effect of attempted eyelid cloure on intraocular preure (IOP) meaurement in normal-tenion (NTG) and high-tenion (HTG) open-angle glaucoma patient. DEIGN: Propective clinical trial METHOD: Forty randomly elected eye of 40 patient underwent corneal pachymetry and IOP meaurement uing both Goldmann applanation tonometry and Tono-pen XL (Mentor, Inc., Norwell, Maachuett, UA). Intraocular preure wa meaured by the ame examiner holding the eyelid open, both with and without the ubject imultaneouly attempting forced eyelid cloure. ubject were eated during all meaurement and waited 5 minute between meaurement with each intrument; the order of meaurement wa randomized. REULT: Twenty NTG and 20 HTG eye were enrolled. The mean age wa 63.0 ± 13.0 year (range, 31–80 year). The average corneal thickne wa 540 ± 32 μm (range, 480–608 μm) in NTG patient and 552 ± 40 μm (range, 449–610 μm) in HTG patient (P = .07, analyi of variance [ANOVA]). Uing Goldmann applanation tonometry, IOP meaurement in eye with NTG increaed by 3.9 ± 2.0 mm Hg with attempted eyelid cloure (P < .0001, paired t tet; range, 2–11 mm Hg). With the Tono-pen XL, IOP meaurement increaed 4.2 ± 2.7 mm Hg (P < .0001, paired t tet; range, 1–14 mm Hg). With attempted forced eyelid cloure, the Goldmann applanation meaurement in eye with HTG increaed 4.1 ± 2.1 mm Hg (P < .0001, paired t tet; range, 1–9 mm Hg). Uing the Tono-pen XL, meaurement increaed 4.5 ± 2.0 mm Hg (P < .0001, paired t tet; range, 2–11 mm Hg). CONCLUION: Attempted eyelid cloure during tonometry i a ignificant and common ource of error in eye with glaucoma and may influence the clinical management and deciion-making in the treatment of NTG and HTG.