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November 1988

'Moustache Glaucoma'

Arch Ophthalmol. 1988;106(11):1503. doi:10.1001/archopht.1988.01060140671008

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To the Editor.  —Although the Goldmann applanation tonometer is a highly accurate instrument, artifacts in measurement of intraocular pressure may occasionally mislead the examiner. Spurious elevations of intraocular pressure may occur on the basis of such patient-related factors as excessive widening of lid fissures,1 blepharospasm, blinking, and tilting of the patient's head.2 Inadvertent pressure exerted on the globe by the examiner while elevating a patient's lid may also cause errors.Occasionally, external factors interfering with the tonometer itself may affect the measurement. Pressure against the arm of a superiorly mounted Goldmann applanation tonometer by an "Afro" hairdo has been reported previously in the Archives.3 We report an analogous situation in which a patient's moustache interfered with the forward movement of the arm of a base-mounted Goldmann applanation tonometer. The patient was a 41-year-old man referred for consultation regarding his pigmentary glaucoma. The initial intraocular pressure reading

Moses RA, Cerniglia PE, Grodzki WJ, et al:  Proptosis and increase of intraocular pressure in voluntary lid fissure widening . Invest Ophthalmol Vis Sci 1984;25:989-992.
Coleman DJ, Trokel S:  Direct recorded intraocular pressure variation in a human subject . Arch Ophthalmol 1969;82:637-640.Article
Purcell J:  Hair glaucoma . Arch Ophthalmol 1973;89:530.Article