Effect of eyelid manipulation and manual jugular compression on intraocular pressure measurement in dogs

Heidi E. Klein Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Sheryl G. Krohne Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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George E. Moore Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
Comparative Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Ahmed S. Mohamed Comparative Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Jean Stiles Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Abstract

Objective—To determine the effect of eyelid manipulation and manual jugular compression on intraocular pressure (IOP) measurement in clinically normal dogs.

Design—Randomized clinical trial.

Animals—30 dogs (57 eyes) without diseases or medications that affect IOP.

Procedures—An applanation tonometer was used to measure IOP during eyelid manipulation or jugular compression. Six manipulations were used in each eye, including minimal eyelid manipulation, maximal dorsoventral extension of the eyelids, lateral eyelid extension, manual compression of the ipsilateral jugular vein, manual compression of both jugular veins, and lateral eyelid extension with manual compression of both jugular veins. Skull type and position of globe in the orbit were recorded.

Results—The 2 manipulations that caused the greatest significant increase in mean IOP were lateral eyelid extension with compression of both jugular veins (difference from baseline IOP, 17.6 mm Hg; 95% confidence interval [CI], 15.7 to 19.5 mm Hg) and lateral eyelid extension alone (16.5 mm Hg; 95% CI, 14.6 to 18.4 mm Hg). Dorsoventral eyelid extension (6.42 mm Hg; 95% CI, 4.5 to 8.3 mm Hg) and compression of both jugular veins alone (3.0 mm Hg; 95% CI, 1.1 to 5.0 mm Hg) significantly increased mean IOP, compared with baseline. Compression of the ipsilateral jugular vein increased mean IOP (0.3 mm Hg; 95% CI, −1.6 to 2.2 mm Hg) from baseline, but not significantly.

Conclusions and Clinical Relevance—Traction on the eyelids or pressure on both jugular veins can significantly increase IOP values as measured by use of applanation tonometry in clinically normal dogs.

Abstract

Objective—To determine the effect of eyelid manipulation and manual jugular compression on intraocular pressure (IOP) measurement in clinically normal dogs.

Design—Randomized clinical trial.

Animals—30 dogs (57 eyes) without diseases or medications that affect IOP.

Procedures—An applanation tonometer was used to measure IOP during eyelid manipulation or jugular compression. Six manipulations were used in each eye, including minimal eyelid manipulation, maximal dorsoventral extension of the eyelids, lateral eyelid extension, manual compression of the ipsilateral jugular vein, manual compression of both jugular veins, and lateral eyelid extension with manual compression of both jugular veins. Skull type and position of globe in the orbit were recorded.

Results—The 2 manipulations that caused the greatest significant increase in mean IOP were lateral eyelid extension with compression of both jugular veins (difference from baseline IOP, 17.6 mm Hg; 95% confidence interval [CI], 15.7 to 19.5 mm Hg) and lateral eyelid extension alone (16.5 mm Hg; 95% CI, 14.6 to 18.4 mm Hg). Dorsoventral eyelid extension (6.42 mm Hg; 95% CI, 4.5 to 8.3 mm Hg) and compression of both jugular veins alone (3.0 mm Hg; 95% CI, 1.1 to 5.0 mm Hg) significantly increased mean IOP, compared with baseline. Compression of the ipsilateral jugular vein increased mean IOP (0.3 mm Hg; 95% CI, −1.6 to 2.2 mm Hg) from baseline, but not significantly.

Conclusions and Clinical Relevance—Traction on the eyelids or pressure on both jugular veins can significantly increase IOP values as measured by use of applanation tonometry in clinically normal dogs.

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